NURS 623 Exam 1 Questions And Answers

Is transmission of Lyme disease likely if the thick attachment is less than 48 hours? - ANS No What is the incubation period of Lyme disease? - ANS 3 to 31 days but typically around 7 to 14 days How many stages does Lyme disease have? - ANS 4 What is the first stage of Lyme disease called? - ANS Early localized Lyme disease What is the second stage of Lyme disease called? - ANS Early disseminated Lyme disease What is the third stage of Lyme disease called? - ANS Late disseminated Lyme disease What is the fourth stage of Lyme disease called? - ANS Late stage or chronic Lyme arthritis Which pathogen causes Lyme disease? - ANS Borrelia burgdorferi What may the patient present with that makes you suspect Lyme disease? - ANS Fever, rash, facial paralysis, arthritis, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes Which test is most commonly used to diagnose Lyme disease? - ANS ELISA Which test is performed to confirm ELISA results with Lyme disease? - ANS Immunoblot test How long may stage 1 Lyme disease (early localized Lyme disease) last for? - ANS 1 to 4 weeks Which symptoms may present with stage 1 (early localized) Lyme disease? - ANS Erythema migrans with bulls eye appearance, flu like symptoms such as fever, chills, joint and muscle pain, stiff neck and headache, general feeling of illness, and swollen lymph glands A circular rash that may expand over time which may also have a bulls eye appearance. - ANS Erythema migrans What is treatment for stage 1 (early localized) Lyme disease? - ANS Doxycycline, Cefuroxime, or amoxicillin How soon may stage 2 (early disseminated) Lyme disease present after initial infection? - ANS Weeks to months With this stage of Lyme disease, symptoms can range from mild to severe, or not at all. Flu like symptoms may be similar to or worse than stage 1 and includes fever, chills, joint and muscle pain, stiff neck and headache, swollen lymph nodes or glands, fatigue, sore throat, visual disturbances such as blurry vision, paralysis or weakness in the face, pain or numbness in the bite area, and heart palpitations. - ANS Stage 2 (early disseminated) Lyme disease What is treatment of stage 2 (early disseminated) Lyme disease if IV treatment is needed? - ANS Azithromycin, doxycycline, amoxicillin, cefuroxime, or ceftriaxone. (Most commonly is doxycycline except for children 8 years old and younger or nursing/pregnant women). What are oral antibiotic choices for treatment of stage 2 (early disseminated) Lyme disease? - ANS Azithromycin, doxycycline (except in children 8 years old, nursing or pregnant women), amoxicillin, and cefuroxime. (Most common is doxycycline except for 8 y.o., pregnant, or nursing). When does stage 3 (late disseminated) Lyme disease typically present? - ANS When the infection has not been treated during stages 1 and 2. It starts months or even years after the original tick bite. What are symptoms of stage 3 (late disseminated) Lyme disease? - ANS Severe headaches, arthritis of the large joints (knees, hips, etc.), heart arrhythmia, brain disturbances (memory loss, mood disturbances, sleep interruptions), difficulty concentrating and mental fogginess, temporary amnesia, difficulty following conversations or speaking, numbness or tingling in the limbs (arms, legs, feet, or hands), extreme fatigue, and temporary paralysis of facial muscles With this stage of Lyme disease, presentation is a recurrent form of joint inflammation which may include episodes of severe arthritis symptoms. The most common joint affected is the knee joint but it may also occur in other large or small joints as well. - ANS Stage 4- late stage or chronic Lyme arthritis Which symptoms will present with stage 4 late stage or chronic Lyme arthritis? - ANS Swelling, redness, and fluid buildup with episodes lasting greater than 6 months