Here is the most common nursing interventions for acute rheumatic fever.
- Monitor temperature frequently, and patient’s response to antipyretics.
- Monitor the patient’s pulse frequently, especially after activity to determine degree of cardiac compensation.
- Auscultate the hear periodically for development of new heart murmur or pericardial or pleural friction rub.
- Observe for adverse effects of salicylate or nonsteroidal anti-inflammatory drug (NSAID) therapy, such as stomach upset, tinnitus, headache, GI bleeding, and altered mental status.
- Monitor the patient’s response to long-term activity restriction.
- Restrict sodium and fluids and obtain daily weights as indicated.
- Administer medications punctually and at regular intervals to achieve constant therapeutic blood levels.
- Explain the need to rest (usually prescribed for 4 to 12 weeks, depending on the severity of the disease and health care provider’s preference) and assure the patient that bed rest will be imposed no longer than necessary.
- Assist the patient to resume activity very gradually once asymptomatic at rest and indicators of acute inflammation have become normal.
- Provide comfort measures.
- Provide safe, supportive environment for the child with chorea.
- Observe for the disappearance or any major or minor manifestations of the disease and report signs of increased rheumatic activity as salicylates or steroids are being tampered.
- Encourage continuous prophylactic antimicrobial therapy to prevent recurrence.