Which vaccine is now recommended for the immunization of all newborns?

The correct answer is choice C. The child needs opportunities to play with peers.

Choice A rationale:

While it's important for children with congenital heart disease to understand their limitations, it's not the primary concern in this scenario. Allowing the child to interact and play with peers is essential for their social, emotional, and psychological development.

Choice B rationale:

While parents play a crucial role in a child's care, completely isolating the child from peers is not ideal. Overprotectiveness can lead to social isolation and hinder the child's ability to develop important social skills.

Choice C rationale:

Children with congenital heart disease should be encouraged to engage in age-appropriate physical activities and play with peers. Of course, the level of activity should be discussed with the child's healthcare provider, but limiting the child's interactions could have negative consequences on their overall development and emotional well-being.

Choice D rationale:

While supervision is important for any child's safety, constant parental supervision to avoid overexertion might not be necessary or feasible. Educating the child about their limitations and providing opportunities for play while monitoring their comfort level is a more balanced approach.

The correct answer is choice B. Cardiac valve damage.

Choice A rationale:

Pulmonary hypertension is not a common complication of rheumatic fever. Rheumatic fever primarily affects the heart, joints, skin, and brain, and pulmonary hypertension is not a typical manifestation of this condition.

Choice B rationale:

Cardiac valve damage is a common and serious complication of rheumatic fever. Rheumatic fever is caused by an autoimmune reaction to untreated streptococcal infections, particularly Streptococcus pyogenes. The immune response targets not only the streptococcal bacteria but also the body's own tissues, especially heart valves. This can lead to inflammation of the heart valves, a condition known as rheumatic heart disease. Over time, repeated bouts of rheumatic fever can result in significant damage to the heart valves, leading to valve insufficiency or stenosis. This can ultimately cause heart failure and other cardiovascular complications.

Choice C rationale:

Seizures are not a common complication of rheumatic fever. Rheumatic fever primarily affects the heart and other body systems, but it does not typically lead to seizures.

Choice D rationale:

Cardiac arrhythmias are possible complications of rheumatic fever, but they are not as common or significant as cardiac valve damage. The inflammation and scarring caused by rheumatic fever can disrupt the electrical pathways of the heart, potentially leading to arrhythmias. However, the more prevalent and severe consequence of rheumatic fever is the damage to the heart valves.