Question Of The Day: School-age Child

Q. On initial assessment of a 7-year-old child with rheumatic fever, which of the following would require contacting the primary care provider immediately?

A. Heart rate of 150 beats/minute.
B. Swollen and painful knee joints.
C. Twitching in the extremities.
D. Red rash on the trunk.



Correct Answer: A

Reason: A heart rate of 150 beats/minute is very high for a 7-year-old child and may indicate carditis. For this age group, the normal heart rate while awake is 70 to 110 beats/minute. Swollen and painful joints such as the knee are characteristic findings in the child with rheumatic fever and do not require immediate physician notification. Twitching in the extremities, known as chorea, is a characteristic finding in a child with rheumatic fever and does not require immediate physician notification. A red rash on the trunk typically indicates rheumatic fever and does not require immediate physician notification.