Which is a priority nursing intervention for a patient with the acute phase of rheumatic fever?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

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Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

Explanation

Rheumatic fever is an inflammatory disease that develops after a Group A Streptococcus infection.
The absolute priority is to eradicate the causative bacteria to stop the abnormal immune response that damages the heart, joints, and central nervous system.
Administering antibiotics, such as penicillin, is the only intervention that treats the underlying cause of the disease.
Prompt antibiotic therapy is crucial to prevent the most severe complication: chronic rheumatic heart disease, which involves permanent damage to heart valves.

Option A: This is contraindicated. During the acute phase, the patient experiences severe, migratory polyarthritis. The joints are inflamed and painful, and movement would exacerbate pain and stress.
Option B: While maintaining hydration is important general supportive care for any patient with a fever, it is not the specific, priority intervention that addresses the cause of rheumatic fever.
Option C: Pain management with anti-inflammatory drugs like aspirin is an important intervention for comfort, but it only treats the symptoms (arthritis, fever). It does not stop the underlying disease process.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Priority nursing interventions for acute rheumatic fever in the correct sequence, documenting the action clearly, and monitoring for the expected response.
The cornerstone of managing acute rheumatic fever is eradicating the streptococcal infection. This prevents the progression to chronic rheumatic heart disease, a major cause of acquired heart disease in children and young adults worldwide.
Nurses play a vital role in educating the patient and family about the importance of completing the full course of antibiotics and adhering to long-term prophylactic therapy to prevent recurrent attacks.
Careful cardiac monitoring is essential. Nurses must be vigilant in assessing for new heart murmurs, tachycardia, chest pain, or signs of heart failure, as carditis is the most serious manifestation.

How to Approach the Question

First, identify the core concept of the question: priority intervention for 'acute rheumatic fever'.
Recall the pathophysiology of rheumatic fever. It is an autoimmune reaction to a bacterial infection (Group A Streptococcus).
Analyze the options based on the principle of treating the root cause versus treating symptoms. Interventions that address the underlying cause are typically the highest priority.
Option D (antibiotics) treats the infection, which is the root cause.
Options A (ROM exercises), B (fluids), and C (pain management) are either contraindicated or address symptoms/supportive care, making them secondary priorities.
Therefore, select the intervention that eradicates the causative agent to prevent long-term complications.

Concept Tested & Keywords

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