Nanda Books

Nursing Care Plan for Rheumatic Heart Disease - Nanda Nursing Diagnosis for RHD

Rheumatic heart disease is a condition in which permanent damage to heart valves is caused by rheumatic fever. The heart valve is damaged by a disease process that generally begins with a strep throat caused by bacteria called Streptococcus, and may eventually cause rheumatic fever.

The symptoms of rheumatic fever usually start about one to five weeks after your child has been infected with Streptococcus bacteria. The following are the most common symptoms of rheumatic fever. However, each child may experience symptoms differently.

Symptoms may include:

• Joint inflammation - including swelling, tenderness, and redness over multiple joints. The joints affected are usually the larger joints in the knees or ankles. The inflammation "moves" from one joint to another over several days.
• Small nodules or hard, round bumps under the skin.
• A change in your child's neuromuscular movements (this is usually noted by a change in your child's handwriting and may also include jerky movements).
• Rash (a pink rash with odd edges that is usually seen on the trunk of the body or arms and legs).
• Fever.
• Weight loss.
• Fatigue.
• Stomach pains.

The symptoms of rheumatic fever may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

Rheumatic fever is uncommon in the US, except in children who have had strep infections that were untreated or inadequately treated. Children ages 5 to 15, particularly if they experience frequent strep throat infections, are most at risk for developing rheumatic fever.

To diagnose this condition, your doctor will ask about recent strep infections, examine your child and use a stethoscope to listen to their heart. In children with rheumatic heart disease, doctors can often hear a heart murmur — the sound of blood moving in the heart in a way that’s not normal.

During the exam, your child’s doctor will look for signs of inflammation in your child’s joints.

The doctor will ask for details about your child’s symptoms, their health history and your family health history. Your doctor may order a throat culture or a blood test to check for strep.

Your child will also need tests that provide information about how their heart looks and works. These may include a chest X-rays or MRI (magnetic resonance imaging) of the heart, echocardiography and electrocardiogram.

Nursing Care Plan for Rheumatic Heart Disease




10 Nursing Diagnosis for Rheumatic Heart Disease - RHD :


1) Decreased Cardiac Output

related to: a disturbance in the closure of the mitral valve (valve stenosis).

2) Ineffective Peripheral Tissue Perfusion

related to: decreased metabolism primarily due to vasoconstriction of peripheral blood vessels.

3) Acute Pain
related to: inflammation of the synovial membrane.

4) Hyperthermia

related to: inflammation of the synovial membrane, and inflammation of the heart valves.

5) Imbalanced Nutrition, Less Than Body Requirements
related to: an increase in stomach acid caused by the sympathetic nervous system compensation.

6) Activity intolerance

related to: muscle weakness, prolonged bed rest or immobilization.

7) Self-Care Deficit

related to: Musculoskeletal Disorders: polyarthritis / arthralgia and therapy bed rest.

8) Impaired Skin Integrity

related to: inflammation of the skin and tissue subcutan.

9) Risk for Impaired Gas Exchange

related to: the accumulation of blood in the lungs due to increased atrial filling.

10) Risk for Injury

related to: involuntary movements, irregular, rapid and muscle weakness / khorea.