A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nosebleeds and is di-agnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember?
a. Blood-borne organisms that adhere to the valvular surface
b. Antigens that bind to the valvular lining, triggering an autoimmune response
c. High fevers that damage collagen in valve leaflets
d. Rheumatoid factor in the blood, stimulat-ing valvular degeneration
ANS: B
The immune response cross-reacts with molecularly similar self-antigens in heart, muscle, joints, and the brain, causing an autoimmune response resulting in diffuse, proliferative, and exudative inflammatory lesions in these tissues. It is not due to blood-borne organisms, high fevers, or rheumatoid factors.
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