CH 24 - Alterations of Cardiovascular Function

A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds and is diagnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember? a. Blood-borne organisms that adhere to the valvular surface b. Antigens that bind to the valvular lining, triggering an autoimmune response c. High fevers that damage collagen in valve leaflets d. Rheumatoid factor in the blood, stimulating valvular degeneration - ANS: B The immune response cross-reacts with molecularly similar self-antigens in heart, muscle, joints, and the brain, causing an autoimmune response resulting in diffuse, proliferative, and exudative inflammatory lesions in these tissues. It is not due to blood-borne organisms, high fevers, or rheumatoid factors. REF: p. 628 A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds. He is diagnosed with rheumatic heart disease. The most likely cause of this disease is: a. congenital heart defects. b. human immunodeficiency virus (HIV) infections. c. group A beta-hemolytic streptococcus infections. d. acute pericarditis. - ANS: C Rheumatic fever is a systemic, inflammatory disease caused by a delayed exaggerated immune response to infection by the group A beta-hemolytic streptococcus, not by congenital heart defects, HIV infections, or acute pericarditis