The nurse is assessing a child suspected of having rheumatic fever in the emergency room. According to Jones criteria, which laboratory findings may indicate the presence of rheumatic fever?


•Rheumatic fever is an autoimmune disease that occurs as a reaction to a group A beta-hemolytic streptococcal infection.

•Inflammation from the immune response leads to fibrin deposits on the endocardium and valves (in particular the mitral valve) and in the major body joints. The disease often follows an attack of pharyngitis, tonsillitis, scarlet fever, ”strep throat,” or impetigo.

Jones criteria states the diagnosis of rheumatic fever can be made with 2 major criteria, or 1 major and 2 minor criteria, along with the evidence of a streptococcal infection.

•Major criteria include polyarthritis, carditis, subcutaneous nodules, erythematic rash, and chorea.

•Minor criteria include fever, elevated ESR, elevated C-reactive protein, leukocytosis, arthralgia, and a prolonged PR interval.

•Incorrect: Chest radiography revealing cardiomegaly and pulmonary congestion, hyponatremia, hyperkalemia, and ventricular hypertrophy are signs of congestive heart failure.

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