N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Review laboratory reports o ELISA testing (enzyme-linked immunosorbent assay) to check for immunoglobulin antibodies; large number of false positives ornegatives o Check sedimentation rate, which is often elevated shortly after infection Nursing diagnosis for Lyme disease: • Risk for activity intolerance related to symptoms and joint pain • Pain related to inflammation of joints, headache, and myalgia • Knowledge deficit related to disease and areas with high Lyme disease risk • Risk for ineffective management of therapeutic regimen related to medications and treatment Nursing interventions for Lyme disease: • Monitor frequently for symptoms and changes • Administer antibiotics per MD order: o Doxycycline or tetracycline: This is the first-line drug of choice for Lyme disease and is given to anyone who tests positive for Lyme disease and is age eight years and older. There is a high risk of allergic reaction to this drug. Side effects include nausea, diarrhea, and a brief worsening of the symptoms of Lyme as the bacteria “die off.” o Penicillin: Second line drug of choice for people allergic to tetracycline. This drug also has a high risk of allergic reactions. May need to be administered via IV for effectiveness. o Clindamycin (Cleocin): Used in combination therapies and for those who are allergic to penicillin or doxycycline. Side effects include severe GI disturbance and risk of irritation to the bowels. o Azithromycin (Zithromax): Used in combination therapies with clindamycin. May be used in patients that are allergic to doxycycline and penicillin. o Ceftriaxone (Rocephin): Can be used via an IV in more severe cases or cases of longer duration (latent Lyme disease). o Some physicians may use two or three of the above antibiotics in combination therapy on rotating weeks since the infection can be hard to treat. • Encourage frequent rest periods and pace activities • Provide assistance with range of motion exercises • Place warm, moist compresses to painful joints • Instruct patient to notify MD of medication side effects, especiallydiarrhea • Give analgesics or anti-inflammatory medications per MD order for pain relief • Teach patient to take antibiotics and finish treatment • Teach prevention of tick bites, teach patient to check body for ticks, avoid tick infested areas, and use insect repellent • Instruct patient to return to physician if symptoms persist or return ©2017 Achieve Test Prep Page 64 of 204 •