Antibiotics are given to treat the streptococcal infection. Treatment with oral penicillin or amoxicillin for 10 days is recommended. Educate the patient/family on the importance of completing the full course of antibiotics.
Because children who have had acute RF are susceptible to recurrence, prophylactic antibiotic treatment is initiated. Patients without carditis often require prophylaxis until age 20 or for a minimum of 5 years, while those with rheumatic carditis/disease may require life-long prophylaxis. It is important to remember that the duration of long-term prophylaxis varies depending on whether the child has cardiac involvement.
A priority treatment goal is the relief of joint pain. Position painful joints for comfort and in proper alignment. Additionally, heat packs, salicylates, or NSAIDs may be administered.
Preventing cardiac complications includes frequent assessment of vital signs and monitoring for increasing signs of cardiac distress. Be sure to promote rest to reduce cardiac workload and seek medical attention if symptoms such as excessive fatigue, dizziness, palpitations, unexplained weight gain, or exertional dyspnea develop.
Because signs and symptoms of RF can be disturbing to both parent and child, providing education is important to the plan of care. Emphasize that the symptoms of chorea are transitory and that, eventually, the movement problems will disappear.
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