Lyme Disease, Lyme Disease Nursing Diagnosis, Lyme Disease Prevention, Lyme Disease Treatment, and 1 Lyme Disease Nursing Care Plan Example

Lyme Disease, Lyme Disease Nursing Diagnosis, Lyme Disease Prevention, Lyme Disease Treatment, and 1 Lyme Disease Nursing Care Plan Example

This study guide is about Lyme disease, Lyme disease nursing diagnosis, Lyme disease prevention, Lyme disease treatment, and 1 Lyme disease nursing care plan example. It can be used to create interventions and care plans for Lyme disease.

Lyme Disease

What is Lyme disease?

Lyme Disease, Lyme Disease Nursing Diagnosis, Lyme Disease Prevention, Lyme Disease Treatment, and 1 Lyme Disease Nursing Care Plan Example
Lyme Disease

Lyme disease is a tick-borne illness caused by the bacteria Borrelia burgdorferi. Following the bite of an infected tick, the disease may begin to show symptoms within 3-30 days. Lyme disease is characterized by rash and symptoms may continue for months or years following onset. Severe cases can lead to organ dysfunction such as heart and liver involvement.

What causes Lyme disease?

In the United States, Lyme disease is caused by the bacteria Borrelia burgdorferi and Borrelia mayonii, carried primarily by black-legged or deer ticks. Young brown ticks often are no bigger than a poppy seed, which can make them nearly impossible to spot.

To contract Lyme disease, an infected deer tick must bite you. The bacteria enter your skin through the bite and eventually make their way into your bloodstream.

In most cases, to transmit Lyme disease, a deer tick must be attached for 36 to 48 hours. If you find an attached tick that looks swollen, it may have fed long enough to transmit bacteria. Removing the tick as soon as possible might prevent infection.

What are the risk factors of Lyme disease?

Where you live or vacation can affect your chances of getting Lyme disease. So can your profession and the outdoor activities you enjoy. The most common risk factors for Lyme disease include:

  • Spending time in wooded or grassy areas. In the United States, deer ticks are found mostly in the heavily wooded areas of the Northeast and Midwest. Children who spend a lot of time outdoors in these regions are especially at risk. Adults with outdoor jobs also are at increased risk.
  • Having exposed skin. Ticks attach easily to bare flesh. If you’re in an area where ticks are common, protect yourself and your children by wearing long sleeves and long pants. Don’t allow your pets to wander in tall weeds and grasses.
  • Not removing ticks promptly or properly. Bacteria from a tick bite can enter your bloodstream if the tick stays attached to your skin for 36 to 48 hours or longer. If you remove a tick within two days, your risk of getting Lyme disease is low.

What are the signs and symptoms of Lyme disease?

Lyme Disease, Lyme Disease Nursing Diagnosis, Lyme Disease Prevention, Lyme Disease Treatment, and 1 Lyme Disease Nursing Care Plan Example
signs and symptoms of Lyme disease

The signs and symptoms of Lyme disease vary. They usually appear in stages, but the stages can overlap.

Early signs and symptoms

A small, red bump, similar to the bump of a mosquito bite, often appears at the site of a tick bite or tick removal and resolves over a few days. This normal occurrence doesn’t indicate Lyme disease.

However, these signs and symptoms can occur within a month after you’ve been infected:

  • Rash. From three to 30 days after an infected tick bite, an expanding red area might appear that sometimes clears in the center, forming a bulls-eye pattern. The rash (erythema migrans) expands slowly over days and can spread to 12 inches (30 centimeters) across. It’s typically not itchy or painful but might feel warm to the touch.

    Erythema migrans are one of the hallmarks of Lyme disease, although not everyone with Lyme disease develops the rash. Some people develop this rash at more than one place on their bodies.

  • Other symptoms. Fever, chills, fatigue, body aches, headache, neck stiffness, and swollen lymph nodes can accompany the rash.

Later signs and symptoms

If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months. These include:

  • Erythema migrans. The rash may appear in other areas of your body.
  • Joint pain. Bouts of severe joint pain and swelling are especially likely to affect your knees, but the pain can shift from one joint to another.
  • Neurological problems. Weeks, months, or even years after infection, you might develop inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell’s palsy), numbness or weakness in your limbs, and impaired muscle movement.

Less common signs and symptoms

Several weeks after infection, some people develop:

  • Heart problems, such as an irregular heartbeat
  • Eye inflammation
  • Liver inflammation (hepatitis)
  • Severe fatigue

What will happen if Lyme disease is left untreated?

Untreated Lyme disease can cause:

  • Chronic joint inflammation (Lyme arthritis), particularly of the knee
  • Neurological symptoms, such as facial palsy and neuropathy
  • Cognitive defects, such as impaired memory
  • Heart rhythm irregularities

What are the expected outcomes for the nursing diagnosis of Lyme disease?

The patient will be infection-free, manage and reduce pain and inflammation; regain optimal mobility, prevent complications

Lyme Disease Nursing Diagnosis

How do you diagnose Lyme disease?

Many signs and symptoms of Lyme disease are often found in other conditions, so diagnosis can be difficult. What’s more, ticks that transmit Lyme disease can also spread other diseases.

If you don’t have the characteristic Lyme disease rash, your doctor might ask about your medical history, including whether you’ve been outdoors in the summer where Lyme disease is common, and do a physical exam.

Lab tests to identify antibodies to the bacteria can help confirm or rule out the diagnosis. These tests are most reliable a few weeks after infection when your body has had time to develop antibodies. They include:

  • Enzyme-linked immunosorbent assay (ELISA) test. The test used most often to detect Lyme disease, ELISA detects antibodies to B. burgdorferi. But because it can sometimes provide false-positive results, it’s not used as the sole basis for diagnosis.

    This test might not be positive during the early stage of Lyme disease, but the rash is distinctive enough to make the diagnosis without further testing in people who live in areas infested with ticks that transmit Lyme disease.

  • Western blot test. If the ELISA test is positive, this test is usually done to confirm the diagnosis. In this two-step approach, the Western blot detects antibodies to several proteins of B. burgdorferi.

Lyme Disease Prevention

What can be done to prevent getting Lyme disease?

The best way to prevent Lyme disease is to avoid areas where deer ticks live, especially wooded, bushy areas with long grass. You can decrease your risk of getting Lyme disease with some simple precautions:

  • Cover up. When in wooded or grassy areas, wear shoes, long pants tucked into your socks, a long-sleeved shirt, a hat, and gloves. Try to stick to trails and avoid walking through low bushes and long grass. Keep your dog on a leash.
  • Use insect repellents. Apply insect repellent with a 20% or higher concentration of DEET to your skin. Parents should apply repellant to their children, avoiding their hands, eyes, and mouth.

    Keep in mind that chemical repellents can be toxic, so follow directions carefully. Apply products with permethrin to clothing or buy pretreated clothing.

  • Do your best to tick-proof your yard. Clear brush and leaves where ticks live. Mow your lawn regularly. Stack wood neatly in dry, sunny areas to discourage rodents that carry ticks.
  • Check your clothing, yourself, your children, and your pets for ticks. Be especially vigilant after spending time in wooded or grassy areas. Deer ticks are often no bigger than the head of a pin, so you might not discover them unless you search carefully.

    It’s helpful to shower as soon as you come indoors. Ticks often remain on your skin for hours before attaching themselves. Showering and using a washcloth might remove unattached ticks.

  • Don’t assume you’re immune. You can get Lyme disease more than once.
  • Remove a tick as soon as possible with tweezers. Gently grasp the tick near its head or mouth. Don’t squeeze or crush the tick, but pull carefully and steadily. Once you’ve removed the entire tick, dispose of it by putting it in alcohol or flushing it down the toilet, and apply antiseptic to the bite area.

Lyme Disease Treatment

What is the most effective treatment for Lyme disease?

Lyme Disease, Lyme Disease Nursing Diagnosis, Lyme Disease Prevention, Lyme Disease Treatment, and 1 Lyme Disease Nursing Care Plan Example
Lyme Disease Treatment

Antibiotics are used to treat Lyme disease. In general, recovery will be quicker and more complete the sooner treatment begins. For early Lyme disease, a short course of oral antibiotics, such as doxycycline or amoxicillin, cures the majority of cases. In more complicated cases, Lyme disease can usually be successfully treated with three to four weeks of antibiotic therapy.

Antibiotics

  • Oral antibiotics. These are the standard treatment for early-stage Lyme disease. These usually include doxycycline for adults and children older than 8, amoxicillin or cefuroxime for adults, younger children, and pregnant or breastfeeding women.

    A 14- to 21-day course of antibiotics is usually recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective.

  • Intravenous antibiotics. If the disease involves the central nervous system, your doctor might recommend treatment with an intravenous antibiotic for 14 to 28 days. This is effective in eliminating infection, although it may take you some time to recover from your symptoms.

    Intravenous antibiotics can cause various side effects, including a lower white blood cell count, mild to severe diarrhea, or colonization or infection with other antibiotic-resistant organisms unrelated to Lyme.

After treatment, a small number of people still have some symptoms, such as muscle aches and fatigue. The cause of these continuing symptoms, known as post-treatment Lyme disease syndrome, is unknown, and treating with more antibiotics doesn’t help.

Some experts believe that certain people who get Lyme disease are predisposed to develop an autoimmune response that contributes to their symptoms. More research is needed.

1 Lyme Disease Nursing Care Plan Example

Subjective Data:

Initial Symptoms

  • Headache
  • Fatigue
  • Muscle/joint pain

Advanced Symptoms:

  • Neck stiffness
  • Nerve pain
  • Short-term memory loss
  • Dizziness
  • Shortness of breath

Objective Data:

Initial Symptoms

  • Bullseye rash (erythema migrans)
  • Fever/chills
  • Swollen lymph nodes

Advanced Symptoms:

  • Facial palsy
  • Inflammation of the brain / spinal cord
  • Palpitations and irregular heartbeats

Nursing Interventions and Rationales

  • Assess skin for rash

The classic, hallmark symptom of Lyme Disease is the bullseye rash at the site of the tick bite that is non-painful and not itchy. Other areas may develop a rash as the disease progresses if not treated.

  • Monitor vital signs

As the disease progresses, it may affect organ systems. Monitor for changes in blood pressure, heart rate, and elevation of temperature.

  • Perform 12-lead ECG

Lyme carditis is a complication of Lyme disease and may cause cardiac dysrhythmias and chest pains.

  • Apply cool compresses to swollen and painful joints

Patients will commonly complain of joint swelling and pain, especially of the knees, which are warm to the touch. Cool compresses help relieve pain and swelling.

  • Provide and promote a calm, low-stress environment

Advanced Lyme disease may cause neurological disorders such as memory loss and irritability. Provide a low-stress environment to help manage neurological symptoms.

  • Assist with ROM exercises; AROM and PROM

Encourage mobility and loosen painful joints

  • Administer medications appropriately

Antibiotics are given as soon as the disease is detected to treat Lyme disease. Other medications may be given to treat symptoms of the disease such as analgesics, NSAIDs to reduce inflammation, and anti-emetics for gastric involvement.

  • Educate patients and family members on ways to reduce the risk of Lyme disease

Prevent re-exposure and further complications

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