Final answer:
The nurse should primarily focus on educating community members to seek treatment for streptococcal pharyngitis to prevent rheumatic fever. Vaccination for streptococcus is not an option since there is no universal streptococcal vaccine, making prompt antibiotic treatment of streptococcal infections most effective for prevention.
Step-by-step explanation:
To decrease the incidence of rheumatic fever in a community, the nurse should focus on prevention through the treatment of streptococcal pharyngitis. Rheumatic fever is a potentially serious sequelae of pharyngitis caused by the bacterium Streptococcus pyogenes, particularly when the infection is untreated or inadequately treated. The most appropriate action would be to teach community members to seek treatment for streptococcal pharyngitis, as early diagnosis and intervention with antibiotics can prevent the progression to acute rheumatic fever. Options such as vaccinating high-risk groups with a streptococcal vaccine, monitoring temperature, or administering prophylactic antibiotics to those with a family history of rheumatic fever, are less effective or practical, primarily because a universal streptococcal vaccine is not available and because rheumatic fever is best prevented by treating the initial streptococcal infection.
Another critical aspect is to ensure adherence to recommended antibiotic treatments, such as penicillin or erythromycin, to fully eradicate the infection and minimize the risk of rheumatic fever. Educating the community on the importance of completing the full course of antibiotics, even after symptoms resolve, is vital to prevent the development of acute rheumatic fever and its severe complications, including permanent heart damage.