NURS 623 Exam 1 Question And Answer Graded A

NURS 623 Exam 1 Question And Answer Graded A Is transmission of Lyme disease likely if the thick attachment is less than 48 hours? - No What is the incubation period of Lyme disease? - 3 to 31 days but typically around 7 to 14 days How many stages does Lyme disease have? - 4 What is the first stage of Lyme disease called? - Early localized Lyme disease What is the second stage of Lyme disease called? - Early disseminated Lyme disease What is the third stage of Lyme disease called? - Late disseminated Lyme disease What is the fourth stage of Lyme disease called? - Late stage or chronic Lyme arthritis Which pathogen causes Lyme disease? - Borrelia burgdorferi What may the patient present with that makes you suspect Lyme disease? - 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? - ELISA Which test is performed to confirm ELISA results with Lyme disease? - Immunoblot test How long may stage 1 Lyme disease (early localized Lyme disease) last for? - 1 to 4 weeks Which symptoms may present with stage 1 (early localized) Lyme disease? - 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. - Erythema migrans What is treatment for stage 1 (early localized) Lyme disease? - Doxycycline, Cefuroxime, or amoxicillin How soon may stage 2 (early disseminated) Lyme disease present after initial infection? - 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. - Stage 2 (early disseminated) Lyme disease What is treatment of stage 2 (early disseminated) Lyme disease if IV treatment is needed? - 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? - 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? - 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? - 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. - Stage 4- late stage or chronic Lyme arthritis Which symptoms will present with stage 4 late stage or chronic Lyme arthritis? - Swelling, redness, and fluid buildup with episodes lasting greater than 6 months How long may symptoms of stage 4 late stage or chronic Lyme arthritis last? - Months to years What history is important for assisting with the diagnosis of Lyme disease? - Exposure to tick bites, recent camping trips, frequent yard work, pets that go outside and have contact with the patient, duration and characteristics of lesion(s). What is the dosage and duration and first line treatment for an adult with early Lyme disease? - Doxycycline 100 mg PO BID for 14-21 days What is the second line treatment for adults with early Lyme disease? - Amoxil 500 mg TID for 14-21 days What is the causative agent of infectious mono? - Epstein Barr virus What is the incubation period for infectious mono? - 30 to 50 days How is mono contacted? - Person via saliva (rarely via blood) What is the common presentation of infectious mono? - Fever, pharyngitis, adenopathy, fatigue, HA, glottis edema, pain behind eyes, petechiae rash on palate What lab test would most likely be elevated with infectious mono? A. hgb B. MCHC C. liver function test D. UA - C What is the duration of infectious mono? - 3 to 4 weeks How long can fatigue last with mono? - 6 to 12 months Which patient education is important to discuss with mono? A. none, it is all in their head B. douching every day C. splenic rest (no contact sports for 3 weeks) D. all of the above - C Which tests should be ordered with infectious mono? - CBC, monospot, RPR titers, IgG, IgM, rapid strep test