Implementation of Nursing Care

Provide Bed Rest and Comfort 

Your major role as a nurse is to provide bed rest to the child and assist the child and parents to understand the need for amount of bed rest. The aim of bed rest is to minimise  the effects  of inflammatory process on all body  systems, and particularly the heart. Nursing procedures  are  carried out quickly  and skillfully  to minimise discomfort. They should be organised as  to assure as few interruptions as possible  to prevent  tiring the patient. A bed cradle is used to prevent pressure on painful  extremities. The nurse supports  the  joints with her hands when moving the patient. While the patient is on bed rest the nurse needs to give special attention to the  skin especially over bony prominencies, light back care, good oral hygiene and small frequent feedings of nourishing  foods. The other  nursing  activities  include prevention of foot drop and constipaton,  skin breakdown, excess weight gain etc. by giving appropriate nursing care  to the child. 

Bed rest may cause psychologic concern for the child's family and the nurse because of inactivity  and its duration. So  it is responsibility of nurse to prevent  the child from frustration  and boredom and involve the child and parents in goal setting while planning nursing care. 

The patients who do not have cardiac  involvement  can be ambulatory in two to three weeks whereas when carditis  is present, immobilisation may have to be continued for two to months.