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Lymes disease is the most common vector-borne disease in the United States and it is caused by the bacterium Borrelia burgdorferi and sometimes, but not often the Borrelia mayonii. It is transmitted by the bite of infected blacklegged tick (deer/bear tick). The tick must be attached for 24-48hours. The chance of getting Lyme’s disease increases the longer the tick is attached.

Signs/symptoms include fever, headache, fatigue, muscle/joint aches, and swollen lymph nodes may occur when there is no rash present. A skin rash called erythema migrans occurs in 70-80 percent of infected persons and begins 3-30 days at the site of the bite. It expands reaching up to 12 inches and is circular (like a target). The rash can appear anywhere on the body and may feel warm but is usually not itchy or painful. Days to weeks after onset of illness include severe headache, neck stiffness, additional rashes of the body, facial palsy (loss of muscle tone/droop on one or both sides), arthritis with severe joint pain and swelling usually in the knees or other large joints, heart palpitations, dizziness, SOB, nerve pain, numbness or tingling in the hands and feet. When left untreated the infection can spread to the joints, heart, and nervous system.

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Typical patient at risk for Lyme Disease:
Patient's of any gender, age, race/ethnicity get Lyme disease if bit by a tick that is infected with  Borrelia burgdorferi bacteria. People most likely to be infected are those that spend a lot of time in heavily wooded or grassy areas.

Causes and or triggers of the condition:
The cause of this disease is being bit by a blacklegged tick that is infected with Borrelia burgdorferi. These ticks live in heavily wooded and grassy areas. They grab onto a human or an animal as they are walking by. Due to the small size of ticks, a person may not know they have been bitten one.

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Common medications to treat Lyme Disease are oral antibiotics. The oral antibiotics include
Doxycycline, Cefuroxime, and Amoxicillin. They are
effective in treating early-stage infection and preventing later stages of the disease. A small amount of people may have lingering fatigue or joint/muscle pain So symptom-based therapies can be quite helpful including Mindful meditation and yoga can be effective in reducing joint pain and providing energy.

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Most IV antibiotics are saved for more severe cases that involve the neuro and cardiac systems. Doxycycline is not recommended for women who are pregnant or lactating and children under the age of eight.

Once the patient has contracted Lyme disease they are still able to get it again so the patient should receive patient education about taking measures to avoid contracting the disease again. The nurse should instruct the patient to wear long sleeves and log pants tucked into boots when going into outdoor areas where ticks may be found. They should apply tick repellant as well. They should also thoroughly inspect their skin for ticks when they return home. Placing clothes directly in the dryer after returning home will kill the ticks and prevent them from entering your home

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Diagnosis is often based on the manifestations, especially erythema migrans (EM), and a history of exposure in an at-risk area.

Lab Tests
The CDC recommends a 2-step laboratory testing process to confirm the diagnosis. (1) an enzyme immunoassay (EIA), which will be positive for most people with Lyme's disease. If the EIA is positive or inconclusive, then (2) a Western blot test. Results are diagnostic of Lyme's disease only if both tests are positive & both tests are done.

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A patient is diagnosed with stage 1 lyme disease, which characteristic will the nurse most likely find on the patient?

A. Signs of neurological disorders
B. Enlarged and inflamed joints
c. Headache
d. Skin rash

ans. D

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Did you know that Avril Lavigne, Shania Twain, Justin Bieber and George W. Bush have been diagnosed with Lyme disease?