The clinic nurse is completing a health history for a client with suspected rheumatic fever (RF). Which question is most important for the nurse to ask to establish a diagnosis?

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11ecbb05_c9e7_441c_b433_fb96f6be81ae_MD0009_00 RF is an acute inflammatory disease of the heart. It is a complication that occurs 2-3 weeks after a streptococcal pharyngitis. RF is caused by a delayed-onset autoimmune reaction involving anti-streptococcal antibodies that cross-react with the antigens in the heart and other organs. Recurrent, untreated streptococcal pharyngitis will lead to faster onset and increased severity of rheumatic heart disease due to increased autoimmune activity. RF affects the heart, skin, joints, and central nervous system. The presence of 2 major criteria or 1 major and 2 minor criteria and evidence of a preceding streptococcal infection indicate a high probability of RF. (Option A) Failing to complete a course of antibiotics can cause illness to reoccur and is the cause of resistant strains of infections. It could contribute to the risk for RF, but it is not part of the criteria for diagnosing it. (Option B) Family history is not a risk factor for RF. (Option D) Fever is a symptom of many illnesses, not just RF. Educational objective: Streptococcal pharyngitis precedes the development of RF by 2-3 weeks. The nurse should ask about a streptococcal throat infection when collecting health history information in a client suspected of having RF.

The Clinic Nurse Is Completing a Health History for a Client