Nursing Care Plan for Lyme Disease

Pathophysiology

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.

Etiology

An infected tick transmits the bacteria into the host (human) through a bite on the skin. The tick, which must be attached for 36-48 hours to transmit bacteria,  may be so small that the host does not realize they have been bitten. Once the bacteria enters the bloodstream, it attacks the tissues and results in pain and inflammation of the joints, neurological symptoms and cardiac dysrhythmias.

Desired Outcome

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

Lyme Disease Nursing Care Plan

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

  1. Assess skin for rash

  2. 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 rash as the disease progresses if not treated.

  3. Monitor vital signs

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

  5. Perform 12-lead ECG

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

  7. Apply cool compresses to swollen and painful joints

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

  9. Provide and promote calm, low stress environment

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

  11. Assist with ROM exercises; AROM and PROM

  12. Encourage mobility and loosen painful joints

  13. Administer medications appropriately

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

  15. Educate patients and family members on ways to reduce risk of Lyme disease

  16. Prevent re-exposure and further complications


References

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