QUESTION
Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion.
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Subject | Nursing | Pages | 4 | Style | APA |
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Answer
Rheumatic Heart Disease
There is significant burden of rheumatic heart disease globally; however, it is largely limited to marginalized and poor populations. In endemic areas, patients often present with heart failure (Kumar et al., 2020). The purpose of this essay is to discuss prevention and health promotion strategies in relation of rheumatic heart disease. It is important to note that effective and timely diagnosis and adequate treatment of the disease can prevent progression into heart failure. One of the key prevention strategies is secondary penicillin prophylaxis, which is done through administration of benzathine penicillin injections. Secondary use of antibiotics can prevent recurrent episodes of group A streptococci and acute rheumatic fever that can cause rheumatic heart disease (Kumar et al., 2020). Diagnosis and appropriate treatment of group A streptococcal pharyngitis is the chief way of preventing acute rheumatic fever (Centers for Disease Control and Prevention (CDC), 2021). Antibiotic prophylaxis helps to reduce the likelihood of recurrent infections/attacks in individuals with a history of acute rheumatic fever (CDC, 2021).
Modification of some environmental factors can help in reduction of the risk of rheumatic heart disease. There is evidence that the disease is associated with socioeconomic deprivation. Public education and better distribution of resources aimed at reduction of overcrowding in areas such as military barracks, slums, and schools is one of the effective approaches for reducing the risk of group A streptococcal infections and development of acute rheumatic fever, which leads to rheumatic heart disease (Katzenellenbogen et al., 2017).
Primordial prevention approaches include reduced overcrowding and improved respiratory and skin hygiene. Other preventive strategies include improved access to health services, maternal education, and reduction of inequalities in the society. Primary prevention strategies include group A streptococci vaccine development and treatment of group A streptococci infections (Katzenellenbogen et al., 2017). Apart from secondary prophylaxis with antibiotics, another secondary prevention strategy is through regular echocardiography to detect cases of asymptomatic rheumatic heart disease (Katzenellenbogen et al., 2017).
Tertiary prevention strategies for rheumatic heart disease include access to surgical intervention for valve lesions and medical management of heart failure and other complications of rheumatic heart failure. Echocardiographic screening of selected groups with high risk of rheumatic heart disease such as pregnant women is highly recommended so as to identify missed diagnoses (Katzenellenbogen et al., 2017). Echocardiography-based screening and active case detection for rheumatic heart disease can occur in various settings, including systematic population-based screening, clinical setting, advocacy projects, research studies, and epidemiological studies (Kumar et al., 2020). In addition, access to dental care, regular clinical review, and access to contraception is another important tertiary prevention strategy for the disease (Katzenellenbogen et al., 2017).
In conclusion, prevention strategies for rheumatic heart disease include adequate antibiotic therapy for group A streptococci infections and reducing overcrowding. Screening and echocardiography and adequate treatment of cases is highly recommended. Better access to health services and surgical procedures can prevention of cute rheumatic fever to rheumatic heart disease.
REFERENCES
Centers for Disease Control and Prevention. (2021). Group A streptococcal (GAS) disease. https://www.cdc.gov/groupastrep/diseases-hcp/acute-rheumatic-fever.html
Katzenellenbogen, J. M., Ralph, A. P., Wyber, R., & Carapetis, J. R. (2017). Rheumatic heart disease: infectious disease origin, chronic care approach. BMC Health Services Research, 17, Article number: 793. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2747-5
Kumar, R. K., Antunes, M. J., Beaton, A., Mirabel, M., Nkomo, V., Okello, E., Regmi, P. R., Remenyi, B., et al. (2020). Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association. Circulation, 142, e337-e357. https://doi.org/10.1161/CIR.0000000000000921