Acute Rheumatic Fever: Recognition, Safe Medication Care, and Prevention for the RPN

Acute rheumatic fever (ARF) is an inflammatory illness that can follow an untreated or partially treated group A streptococcal (GAS) throat infection. It affects the heart, joints, brain, skin and the tissue under the skin. Most attacks occur in children and adolescents aged 5 to 15 years. The joint pain and the rash settle without lasting damage, but inflammation of the heart valves can leave permanent scarring called rheumatic heart disease (RHD), which may cause heart failure years later. ARF is now uncommon in most of Canada, but it still occurs, with a higher burden in some First Nations and Inuit communities, in remote northern settings with crowded housing and limited access to care, and in newcomers from regions where RHD remains common. The registered practical nurse (RPN) caring for a stable child or adolescent with ARF collects data, recognizes expected and abnormal findings, gives medications safely, supports comfort and safety, teaches prevention, and reports changes promptly to the registered nurse (RN) or prescriber. The RPN does not diagnose ARF or decide treatment, but accurate observation often provides the first...