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NUR1201 - Family Centered Care for an Adolescent Girl - Report

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Charles Sturt University

   

Nursing (NUR1201)

   

Added on  2020-03-01

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NUR1201 - The purpose of this study is to discuss the pathophysiology of the disease and to evaluate the appropriate caregiving process in relation to the mentioned case study of the 14-year-old girl with ARF/RHD.

NUR1201 - Family Centered Care for an Adolescent Girl - Report

   

Charles Sturt University

   

Nursing (NUR1201)

   Added on 2020-03-01

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Running head: FAMILY CENTERED CARE FOR AN ADOLESCENT GIRLFamily centered care for an adolescent girlName of the StudentName of the UniversityAuthor note
NUR1201 - Family Centered Care for an Adolescent Girl - Report_1
1FAMILY CENTERED CARE FOR AN ADOLESCENT GIRLRheumatic fever is a very common amongst the children and happens after astreptococcus throat infection. It is an inflammatory disease, which affects the heart, skin,joints and brain. Sometimes, the rheumatic fever leads to the damage of the heart valves. Thistype of heart disease is called Rheumatic heart disease (RHD). The essay follows a case study of a 14 years old adolescent girl named Sue. This girlhas been treated repeatedly for impetigo and streptococcal pharyngitis for the last two years.The girl receives IM antibiotics (Penicillin) in a local clinic. After missing her antibioticsmultiple times, she was admitted to a local clinic with the classic ARF (Acute RheumaticFever) symptoms. The purpose of this study is to discuss the pathophysiology of the disease and toevaluate the appropriate caregiving process in relation to the mentioned case study of the 14-year-old girl with ARF/RHD.Rheumatic Fever occurs two to four weeks after a throat infection caused by thebacteria called Streptococcus pyrogenes. RHD affects more or less 15 million people per yearand every year, the number of death ads up to as much as 230000 (Rhdaustralia.org.au,2017). The symptoms of this disease include severe pain in the joints, fever, and involuntarymuscle movement. Sometimes a non-itchy rash (Erythema marginatum) appears along withthese symptoms. Sometimes RHD causes permanent damage to the heart and the patient mayrequire valve replacement surgery because of this. The patient Sue, mentioned in the casestudy is suffering from ARD for more than two years and receives IM antibiotics to lessen therisk of developing RHD (Burke, & Chang, 2014). The symptoms start to show one to three weeks after the occurrence of thestreptococcal pharyngitis. The Rheumatic fever affects the connective tissues present around
NUR1201 - Family Centered Care for an Adolescent Girl - Report_2
2FAMILY CENTERED CARE FOR AN ADOLESCENT GIRLthe heart arterioles. The proteins present on the cell wall of Streptococcus pyrogens showsmolecular mimicry and causes inflammation by cross-reacting with the connective tissues.The cross reactivity is also termed as the molecular mimicry and is a Type 2 hypersensitivityreaction (Cunningham, 2014). The streptococcal infection induces the B cells to take theantigen to T cells (CD4+). This, in turn induces the CD4+ cells to become the helper T cells.These helper T cells in turn activate the B cell to become plasma cells. These plasma cellsinduce the antibodies to the bacterial cell walls. These antibodies react against the joints andthe myocardium of the patient (Perricone et al., 2014). The outer wall of the bacteria has branched polymers (M proteins) which mimics thevalvular endothelium and myosin present in the heart. The antibodies presented by theplasma cells recognize laminin, a protein that structures the basement membrane of thecardiac valves (Cunningham, 2012). Valves like tricaspic, mitral, aortic, and pulmonary, getmore affected by the rheumatic fever. In acute RHD, formation of the minor thrombi happens at the valve closure. Inchronic RHD, the valve basement membrane thickens and valve fibrosis can be seen. Thesecommonly results in stenosis and rarely causes regurgitation (Iung, & Vahanian, 2014). The T cells which reacts with the bacterial M protein, infiltrates the endotheliumtissues present in the valve, then it gets activated after binding with the interleukins andTNF(tumor necrosis factor). Th17, a kind of cytokine plays the most important role in theRHD development. The chosen case study is of a 14-year-old patient named Sue, a resident of a remotecommunity in Australia. The girl has a two year of history of streptococcal pharyngitis. Thelocal health clinic gives her Penicillin G IM antibiotics in regular basis; however, she missed
NUR1201 - Family Centered Care for an Adolescent Girl - Report_3

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