Nursing Care Plan (NCP) for Lyme Disease
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Outline
Lesson Objective for Lyme Disease
- Understanding Lyme Disease:
- Gain a comprehensive understanding of Lyme disease, including its etiology, pathophysiology, and the specific microorganism responsible (Borrelia burgdorferi). Identify the primary modes of transmission and geographical areas where Lyme disease is prevalent.
- Recognition of Clinical Manifestations:
- Learn to recognize the clinical manifestations and symptoms associated with Lyme disease, such as erythema migrans, flu-like symptoms, joint pain, and neurological complications. Understand the potential for varied presentations in different stages of the disease.
- Diagnostic Methods:
- Familiarize oneself with the diagnostic methods for Lyme disease, including serological tests like ELISA and Western blot. Understand the limitations and challenges in diagnosing Lyme disease accurately, especially in the early stages.
- Treatment Strategies:
- Explore the recommended treatment modalities for Lyme disease, including antibiotic therapy. Understand the importance of early intervention to prevent complications and chronic sequelae. Learn about the variations in treatment approaches based on the stage of the disease.
- Prevention and Patient Education:
- Acquire knowledge about preventive measures, such as avoiding tick exposure, using protective clothing, and conducting thorough tick checks. Understand the importance of patient education in promoting awareness, early detection, and adherence to preventive practices.
Pathophysiology of Lyme Disease
- Bacterial Transmission:
- Lyme disease is caused by the spirochete bacterium Borrelia burgdorferi, primarily transmitted through the bite of infected black-legged ticks (Ixodes scapularis or Ixodes pacificus).
- Multi-Stage Infection:
- The infection progresses through multiple stages: localized infection, early disseminated infection, and late persistent infection. Each stage presents distinct clinical features and complications.
- Localized Infection (Early Stage):
- Following a tick bite, an erythema migrans (EM) rash may appear at the site of infection, indicating local spread. This stage is often accompanied by flu-like symptoms, such as fever, fatigue, and muscle aches.
- Early Disseminated Infection:
- B. burgdorferi can disseminate through the bloodstream, leading to more widespread symptoms. Neurological, cardiac, and musculoskeletal manifestations may occur. Multiple EM rashes, facial palsy, and heart conduction abnormalities are possible.
- Late Persistent Infection:
- If untreated, Lyme disease can progress to chronic stages, with persistent symptoms affecting joints, the nervous system, and other organs. Chronic Lyme arthritis and neurological complications, such as cognitive impairment, may develop.
Etiology of Lyme Disease
- Bacterial Cause:
- Lyme disease is caused by the spirochete bacterium Borrelia burgdorferi, with Borrelia mayonii and Borrelia afzelii also implicated in certain regions. These bacteria are transmitted to humans through the bite of infected black-legged ticks.
- Vector Transmission:
- Ticks of the Ixodes genus, particularly Ixodes scapularis (commonly known as the black-legged or deer tick) in the eastern United States and Ixodes pacificus in the western United States, are the primary vectors of Lyme disease.
- Reservoir Hosts:
- Small mammals, particularly rodents like mice and birds, serve as reservoir hosts for the Lyme disease bacterium. Ticks acquire the infection when feeding on these reservoir hosts.
- Geographic Distribution:
- Lyme disease is most prevalent in certain geographic regions, including wooded and grassy areas where ticks carrying the bacterium are abundant. It is more commonly reported in the northeastern, north-central, and Pacific coastal regions of the United States.
- Seasonal Risk:
- The risk of Lyme disease transmission is highest during the warmer months (spring and summer) when ticks are most active and people engage in outdoor activities. Timely removal of attached ticks reduces the risk of infection.
Desired Outcome of Nursing Care for Lyme Disease
- Resolution of Symptoms:
- Alleviation of presenting symptoms such as erythema migrans (characteristic rash), flu-like symptoms, joint pain, and neurological manifestations, leading to the restoration of the patient’s overall well-being.
- Prevention of Complications:
- Early detection and treatment to prevent the progression of Lyme disease and reduce the risk of complications, including disseminated infection, cardiac involvement, and neurological sequelae.
- Negative Serology:
- Achieving negative or significantly reduced levels of specific antibodies against Borrelia burgdorferi in follow-up serological tests, indicating a successful response to treatment and reduced bacterial load.
- Restoration of Function:
- Regaining normal function and activities of daily living by managing and resolving symptoms, particularly those affecting joints, muscles, and neurological function.
- Education and Prevention:
- Empowering the patient with knowledge about Lyme disease, its prevention, and the importance of early intervention. This includes educating individuals about tick avoidance strategies, proper tick removal, and the significance of seeking medical attention if symptoms develop after a tick bite.
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 Assessment for Lyme Disease
- Patient History:
- Thoroughly document the patient’s history, including recent outdoor activities, exposure to wooded or grassy areas, and any known tick bites.
- Symptom Assessment:
- Evaluate and document the presence and severity of symptoms, such as erythema migrans (bull’s-eye rash), fever, fatigue, headache, muscle and joint pain, and neurological symptoms (e.g., Bell’s palsy).
- Skin Examination:
- Perform a comprehensive examination of the skin to identify and document the presence of erythema migrans or other skin manifestations associated with Lyme disease.
- Joint Assessment:
- Assess joints for signs of inflammation, pain, and limitation of movement. Focus on commonly affected joints, such as the knees.
- Neurological Assessment:
- Conduct a neurological assessment, including cranial nerve examination, to identify any neurological deficits or abnormalities, especially if the patient presents with symptoms like facial paralysis or cognitive changes.
- Laboratory Tests:
- Coordinate with the healthcare team to obtain laboratory tests, including serological tests for Lyme antibodies (e.g., enzyme immunoassay and Western blot), to confirm the diagnosis and monitor treatment response.
- Psychosocial Assessment:
- Evaluate the patient’s emotional well-being, addressing concerns, fears, or anxieties related to the diagnosis and potential complications. Identify any impact on daily activities and relationships.
- Educational Assessment:
- Assess the patient’s knowledge about Lyme disease, its transmission, and preventive measures. Identify areas where education is needed and provide information about proper tick removal and the importance of early medical intervention.
Implementation for Lyme Disease
- Administer Antibiotic Therapy:
- Initiate and monitor the administration of prescribed antibiotics, typically doxycycline, amoxicillin, or cefuroxime, to target the causative bacterium (Borrelia burgdorferi). Ensure adherence to the prescribed dosage and duration.
- Pain Management:
- Provide pain relief measures to address joint and muscle pain associated with Lyme disease. Administer analgesics as ordered, and assess the effectiveness of pain management strategies.
- Educate on Prevention:
- Educate the patient on preventive measures, including avoiding tick-infested areas, using insect repellent, wearing protective clothing, and conducting thorough tick checks after outdoor activities.
- Joint Support and Rehabilitation:
- Collaborate with physical therapy services to develop a joint support and rehabilitation plan. Assist the patient in maintaining joint function and preventing complications associated with Lyme arthritis.
- Monitor and Manage Symptoms:
- Regularly assess and monitor the patient’s symptoms, including skin manifestations, joint pain, and neurological symptoms. Implement interventions to manage specific symptoms, such as applying topical treatments for skin manifestations or providing supportive care for neurological symptoms.
Nursing Interventions and Rationales
- Assess skin for rash
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.
- Monitor vital signs
As the disease progresses, it may affect organ systems. Monitor for changes in blood pressure, heart rate and elevation of temperature.
- Perform 12-lead ECG
Lyme carditis is a complication of Lyme disease and may cause cardiac dysrhythmias and chest pains.
- Apply cool compresses to swollen and painful joints
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.
- Provide and promote calm, low stress environment
Advanced Lyme disease may cause neurological disorders such as memory loss and irritability. Provide low stress environment to help manage neurological symptoms.
- Assist with ROM exercises; AROM and PROM
Encourage mobility and loosen painful joints
- Administer medications appropriately
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.
- Educate patients and family members on ways to reduce risk of Lyme disease
Prevent re-exposure and further complications
Evaluation for Lyme Disease
- Resolution of Symptoms:
- Evaluate the extent to which Lyme disease symptoms have resolved or improved. This includes assessing the disappearance of skin manifestations, reduction in joint pain, and resolution of neurological symptoms.
- Laboratory Tests:
- Monitor laboratory results, especially serological tests for Lyme disease. Assess whether titers have decreased or become negative, indicating a response to treatment and a reduction in the presence of the causative bacterium.
- Functional Status:
- Evaluate the patient’s overall functional status, including their ability to perform daily activities and engage in physical and social activities. Improvement in functional status indicates a positive response to treatment.
- Patient Education and Compliance:
- Assess the patient’s understanding of preventive measures and their compliance with recommendations. Evaluate whether the patient has adopted practices to reduce the risk of future tick exposure and Lyme disease recurrence.
- Quality of Life:
- Consider the impact of Lyme disease and its treatment on the patient’s quality of life. Assess psychological well-being, the ability to participate in work or recreational activities, and overall satisfaction with the treatment outcomes.
References
- https://www.cdc.gov/lyme/signs_symptoms/index.html
- https://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease#4-8
- https://www.mayoclinic.org/diseases-conditions/lyme-disease/symptoms-causes/syc-20374651
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Transcript
Today, we are talking about Lyme disease. Okay. I’m sure many of you have heard of Lyme disease, but Lyme disease is a tick-borne illness that is caused by the bacteria Borrelia burgdorferi, and it happens after you are bitten by an infected tick. The disease can show symptoms for 30 days after. The main characterization, the symptoms are rash and they can continue for months or a year. Following the initial onset, severe cases can lead to organ dysfunction, such as heart and liver involvement. Some of the nursing considerations that we want to do, we want to assess for a bullseye rash. I have a picture of that for you, but we want to assess for a bullseye rash. That is the hallmark sign that you have been infected with Lyme disease. We also want to assess the patient’s neurological status and heart sounds. We want to take a list of the heart sounds, and we want to monitor the heart with ECG for arrhythmias. The desired outcomes for the patient to be infection-free.
We want to manage and reduce the pain and inflammation. We want to make sure the patient regains optimal mobility, and we want to prevent complications. So this right here is a photo of a bullseye rash. So you see it has the, the red ring around, and then it has a little bullseye. It looks just like a bullseye, but just remember bullseye Lyme disease. Okay. Because that is going to be on your NCLEX. Trust me. Some of the subjective data; there are typically two phases. When you think of Lyme disease, there is going to be the initial set of symptoms and there as the condition progresses. And then that’s what we get into the advanced symptoms. So some initial symptoms for Lyme disease include headache. We are going to have some fatigue. We are going to have some muscle and joint pain, and we’re going to also advance to some of the advanced symptoms.
So these are all subjective things. So we’re going to have some nerve pain; once we get nerve involvement, we’re pretty far along. So we’re going to have some nerve pain. We’re going to have some short term memory loss, dizziness, shortness of breath. Some of the things that we’re going to observe, some of the objective data. Initially, we are going to see the bullseye rash. So that is that red ring that looks like a bullseye. The patient is also going to have a fever and chills and swollen lymph nodes. Once we get advanced, there’s going to be some facial palsy.
So, you know, that’s the drooping of the face. There’s also going to be some inflammation of the brain or spinal cord as well as palpitations or irregular heartbeat. So as nurses, we are going to assess the skin; we’re going to assess the skin for a rash. The classic hallmark symptom of Lyme disease is that bullseye rash. So,we want to assess for that. Other areas may develop a rash as disease progresses, if not treated. So that could also be a part of the advanced symptoms as well. We’re gonna perform a 12 lead EKG or ECG for myocarditis, which is the arrhythmias that occur. It’s just a complication of Lyme disease. So we do not want those dysrhythmias because those can be fatal if untreated. Okay, we’re going to apply cool compresses. You know, everything does not have to be pharmacological.
We don’t always have to use medicine. We can apply warm compresses because those joints are going to be red and inflamed and tender. So we want to apply some whole compresses just to help relieve some of that pain and some of that swelling. Okay, we’re going to administer the medications appropriately. So antibiotics are to be given as soon as the disease is detected, because the quicker we can start on treating it the quicker we can add those symptoms. And hopefully we can get over that hump of Lyme disease. Also, we want to think about the pain. So we want to use things like analgesics. We want to use NSAIDs to reduce the inflammation at times, medications for any gastric involvement, because these patients also tend to have some nausea and vomiting.
We’re going to educate the family and the patient; we’re going to educate them on how to reduce the risk of Lyme disease, because it is a tick borne illness. We want to make sure that we can prevent re-exposure so that we can avoid those further complications. So, you know, things like wearing long pants and long socks when you’re in the woods, tucking your pants into your socks, long sleeve shirts, and just covering your body, and also assessing your body, checking your body for ticks as well. Okay. And the final thing is something that we should do if we want to assess the patient with range of motion. Okay, we want to assist with range of motion, because again, those joints are stiff. Those joints are inflamed. So the patient is not going to want to move, but we go, we’re going to need to get those joints moving to kind of get that blood flow working as we work on that inflammation.
We’ll encourage mobility and loosen those painful joints. Some key points, Lyme disease is caused by ticks. They are caused specifically by the deer tick. Some subjective and objective data that we want to just keep in mind are headache, nerve pain, dizziness, and fatigue. Those are some of the most common things that patients are going to present with. We’re going to look for that bullseye rash. That’s the hallmark sign. We’re going to look with the EKG for irregular heartbeats. We’re going to look for some facial palsy. Remember the facial palsy is going to be something that is further down the bullseye rash. That is our hallmark sign. That is the number one thing we’re going to look for. And remember that bullseye rash is not itchy. So we’re going to want to do a good visual assessment of the skin. We’re also going to do some cardiac monitoring, the 12 lead for dysrhythmias. We’re going to do frequent vital signs. Okay. Endocarditis is a complication that can cause that fatal arrhythmia. Okay. We love you guys. Go out and be your best self today. And, as always, happy nursing.
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Hyperthermia (Thermoregulation)
Hyperthyroidism Case Study (75 min)
Hypertonic Solutions (IV solutions)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoparathyroidism
Hypothermia (Thermoregulation)
Hypotonic Solutions (IV solutions)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
ICU Nurse Report to OR (Operating)Team
Immunology Module Intro
Impulse Transmission
Inflammatory Bowel Disease Case Study (45 min)
Informed Consent
Inserting a Foley (Urinary Catheter) – Male
Inserting an NG (Nasogastric) Tube
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Intake and Output (I&O)
Integumentary (Skin) Course Introduction
Integumentary (Skin) Important Points
Integumentary (Skin) Module Intro
Interventional Radiology
Interventions for Aphasia Nursing Mnemonic (PROP)
Intracranial Pressure ICP
Intraoperative (Intraop) Complications
Intraoperative Nursing Priorities
Intraoperative Positioning
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Intro to Health Assessment
Introduction to Health Assessment
Intubation in the OR
Iodine Nursing Considerations
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Isoniazid (Niazid) Nursing Considerations
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Kidney Cancer
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Leukemia
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Leukemia Case Study (60 min)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Levofloxacin (Levaquin) Nursing Considerations
Levothyroxine (Synthroid)
Lidocaine (Xylocaine) Nursing Considerations
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Linen Change
Lipase Lab Values
Lisinopril (Prinivil) Nursing Considerations
Live Bedside Report Medsurg (Medical surgical)
Liver Cancer
Liver/Gallbladder Module Intro
Local Anesthesia
Loperamide (Imodium) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Lower Gastrointestinal (GI) Module Intro
Lung Cancer
Lung Diseases Module Intro
Lymphatic Assessment
Lymphoma
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Malignant Hyperthermia
Mammogram
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Management of Lyme Disease Nursing Mnemonic (BAR)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Mechanical Aids
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Medications for Pancreatitis Nursing Mnemonic (Please Make Tummy Better)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Melanoma
Meniere’s Disease
Meperidine (Demerol) Nursing Considerations
Meropenem (Merrem) Nursing Considerations
Metabolic & Endocrine Module Intro
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic/Endocrine Course Introduction
Metformin (Glucophage) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
MI Surgical Intervention
Migraines
Miscellaneous Nerve Disorders
Mobility & Assistive Devices
Moderate Sedation
Montelukast (Singulair) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Multiple Myeloma
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Musculoskeletal Assessment
Musculoskeletal Course Introduction
Musculoskeletal Module Intro
Myocardial Infarction (MI) Case Study (45 min)
Myocardial Infarction Nursing Mnemonic (MONATAS)
Naproxen (Aleve) Nursing Considerations
Nasal Disorders
Neostigmine (Prostigmin) Nursing Considerations
Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro A&P Module Intro
Neuro Anatomy
Neuro Assessment Module Intro
Neuro Course Introduction
Neuro Disorders Module Intro
Neuro Trauma Module Intro
Neurological Fractures
NG (Nasogastric)Tube Management
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
NRSNG Live | So You Want to be a Surgical Nurse?
Nuclear Medicine
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Chlamydia (STI)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Compartment Syndrome
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Epididymitis
Nursing Care and Pathophysiology for Gonorrhea (STI)
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Human Papilloma Virus (HPV STI)
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Nursing Care and Pathophysiology for Lyme Disease
Nursing Care and Pathophysiology for Male Infertility
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Osteomyelitis
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Polycystic Ovarian Syndrome (PCOS)
Nursing Care and Pathophysiology for Psoriasis
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Seizure
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Testicular Torsion
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Pneumonia
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Bell’s Palsy
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Bladder Cancer
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Bone Cancer (Osteosarcoma, Chondrosarcoma, and Ewing Sarcoma)
Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Brain Tumors
Nursing Care Plan (NCP) for Breast Cancer
Nursing Care Plan (NCP) for Bronchoscopy (Procedure)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cellulitis
Nursing Care Plan (NCP) for Cervical Cancer
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Colorectal Cancer (Colon Cancer)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Dementia
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Emphysema
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epididymitis
Nursing Care Plan (NCP) for Gastroesophageal Reflux Disease (GERD)
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Gout / Gouty Arthritis
Nursing Care Plan (NCP) for Guillain-Barre
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Herpes Zoster – Shingles
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hyperthermia (Thermoregulation)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Kidney Cancer
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Lung Cancer
Nursing Care Plan (NCP) for Lyme Disease
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Meniere’s Disease
Nursing Care Plan (NCP) for Multiple Sclerosis (MS)
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Osteoarthritis (OA), Degenerative Joint Disease
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Ovarian Cancer
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Pneumothorax/Hemothorax
Nursing Care Plan (NCP) for Polycystic Ovarian Syndrome (PCOS)
Nursing Care Plan (NCP) for Pressure Ulcer / Decubitus Ulcer (Pressure Injury)
Nursing Care Plan (NCP) for Prostate Cancer
Nursing Care Plan (NCP) for Psoriasis
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Restrictive Lung Diseases
Nursing Care Plan (NCP) for Rhabdomyolysis
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Skin cancer – Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer)
Nursing Care Plan (NCP) for Stroke (CVA)
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Testicular Cancer
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Thyroid Cancer
Nursing Care Plan (NCP) for Tuberculosis
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) for West Nile Virus
Nursing Care Plan for (NCP) Trigeminal Neuralgia
Nursing Care Plan for Amputation
Nursing Care Plan for Chlamydia (STI)
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan for Compartment Syndrome
Nursing Care Plan for Coronary Artery Disease (CAD)
Nursing Care Plan for Distributive Shock
Nursing Care Plan for Endometriosis
Nursing Care Plan for Fibromyalgia
Nursing Care Plan for Fractures
Nursing Care Plan for Gastritis
Nursing Care Plan for Gonorrhea (STI)
Nursing Care Plan for Hemorrhoids
Nursing Care Plan for Herpes Simplex (HSV, STI)
Nursing Care Plan for Hiatal Hernia
Nursing Care Plan for Liver Cancer
Nursing Care Plan for Macular Degeneration
Nursing Care Plan for Myocarditis
Nursing Care Plan for Nasal Disorders
Nursing Care Plan for Osteomyelitis
Nursing Care Plan for Pelvic Inflammatory Disease (PID)
Nursing Care Plan for Pulmonary Edema
Nursing Care Plan for Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care Plan for Scleroderma
Nursing Care Plan for Syphilis (STI)
Nursing Care Plan for Testicular Torsion
Nursing Case Study for Acute Kidney Injury
Nursing Case Study for Breast Cancer
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Colon Cancer
Nursing Case Study for Diabetic Foot Ulcer
Nursing Case Study for Hepatitis
Nursing Case Study for Pneumonia
Nursing Case Study for Rheumatic Heart Disease
Nursing Case Study for Rheumatoid Arthritis
Nursing Case Study for Type 1 Diabetes
Nursing Skills Course Introduction
Nutrition (Diet) in Disease
Nutrition-related Diseases
Omeprazole (Prilosec) Nursing Considerations
Oncology Important Points
Oncology Module Intro
Oncology nurse
Ondansetron (Zofran) Nursing Considerations
Opioids
Osteosarcoma
Ovarian Cancer
Oxygen Delivery Module Intro
Pacemakers
Pain and Nonpharmacological Comfort Measures
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Pain Assessments for Certified Perioperative Nurse (CNOR)
Pantoprazole (Protonix) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Patient Positioning
Patients with Communication Difficulties
Pentobarbital (Nembutal) Nursing Considerations
Peptic Ulcer Disease Case Study (60 min)
Performing Cardiac (Heart) Monitoring
Perioperative Nursing Course Introduction
Perioperative Nursing Roles
Peripheral Vascular Assessment
Peritoneal Dialysis (PD)
Phenazopyridine (Pyridium) Nursing Considerations
Phenobarbital (Luminal) Nursing Considerations
Phosphorus (PO4) Blood Test Lab Values
Pituitary Adenoma
Plant Alkaloids Topoisomerase and Mitotic Inhibitors
Pneumonia Concept Map
Pneumonia Labs
Pneumonia Risk Factors Nursing Mnemonic (VENTS)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Positioning
Post-Anesthesia Recovery
Postoperative (Postop) Complications
PPE Donning & Doffing
Premature Atrial Contraction (PAC)
Premature Ventricular Contraction (PVC)
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
Preoperative (Preop)Assessment
Pressure Line Management
Pressure Ulcers/Pressure injuries (Braden scale)
Procalcitonin (PCT) Lab Values
Propofol (Diprivan) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Propylthiouracil (PTU) Nursing Considerations
Prostate Cancer
Prostate Nursing Mnemonic (FUN)
Prostate Specific Antigen (PSA) Lab Values
Protein in Urine Lab Values
Proton Pump Inhibitors
Pulmonary edema treatment Nursing Mnemonic (MAD DOG)
Pupil Reactions Nursing Mnemonic (PERRLA)
Radiation Cancer Treatment
Ranitidine (Zantac) Nursing Considerations
Reactivation of Herpes Zoster Nursing Mnemonic (FICA)
Reasons for a Bronchoscopy Nursing Mnemonic (Please Assess His Weird Bronchoscopy Results)
Reasons for Chest Tube Nursing Mnemonic (Don’t Ever Fail)
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Respiratory A&P Module Intro
Respiratory Alkalosis
Respiratory Course Introduction
Respiratory Infections Module Intro
Respiratory Procedures Module Intro
Respiratory Trauma Module Intro
Restrictive Lung Disease Causes Nursing Mnemonic (PAINT)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Rifampin (Rifadin) Nursing Considerations
Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)
Risk Factors for Osteoporosis Nursing Mnemonic (ACCESS)
Routine Neuro Assessments
Science of Nutrition
Scleroderma Symptoms Nursing Mnemonic (CREST)
Sedatives-Hypnotics
Sedatives-Hypnotics
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Therapeutic Management
Seizures Case Study (45 min)
Seizures Module Intro
Sepsis Concept Map
Sepsis Labs
Septic Shock (Sepsis) Case Study (45 min)
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shock Module Intro
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Sinus Bradycardia
Sinus Tachycardia
Skin Cancer
Specialty Diets (Nutrition)
Spinal Cord Injury
Spinal Cord Injury Case Study (60 min)
Spinal Precautions & Log Rolling
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
Stages of Hepatitis Nursing Mnemonic (PIP)
Sterile Field
Sterile Gloves
Stoke Assessments Nursing Mnemonic (FAST)
Stomach Cancer (Gastric Cancer)
Strabismus
Streptokinase (Streptase) Nursing Considerations
Stroke (CVA) Module Intro
Stroke Assessment (CVA)
Stroke Case Study (45 min)
Stroke Concept Map
Stroke Nursing Care (CVA)
Stroke Therapeutic Management (CVA)
Sucralfate (Carafate) Nursing Considerations
Supraventricular Tachycardia (SVT)
Surgical Incisions & Drain Sites
Surgical Prep
Sympatholytics (Alpha & Beta Blockers)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Symptoms of Wernicke’s Encephalopathy Nursing Mnemonic (COAT)
Systemic Lupus Erythematosus (SLE)
TB Drugs Nursing Mnemonic (RIPE)
Tension and Cluster Headaches
Testicular Cancer
Tetracycline (Panmycin) Nursing Considerations
The 5-Minute Assessment (Physical assessment)
The Medical Team
Thoracentesis
Thrombin Inhibitors
Thrombocytopenia
Thrombolytics
Thyroid Cancer
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
To Clot or Not To Clot – Anticoagulants! – Live Tutoring Archive
Total Iron Binding Capacity (TIBC) Lab Values
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Trach Care
Trach Suctioning
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)
Triiodothyronine (T3) Lab Values
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Troponin I (cTNL) Lab Values
Tuberculosis (TB) Case Study (60 min)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Types of Hemorrhoids Nursing Mnemonic (Pie)
Ulcerative Colitis – Assessment Nursing Mnemonic (MADE 10)
Ultrasound
Understanding Blood Pressure Meds! – Live Tutoring Archive
Upper Gastrointestinal (GI) Module Intro
Urinary Elimination
Urinary Tract Infection Case Study (45 min)
Urine Culture and Sensitivity Lab Values
Using Aseptic Technique
Vancomycin (Vancocin) Nursing Considerations
Varicocele
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasopressin
Vasopressin (Pitressin) Nursing Considerations
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms
Ventilator Settings
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Vessels & Fluid
Vitamin D Lab Values
Warfarin (Coumadin) Nursing Considerations
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Selecting a Dressing
Wound Care – Wound Drains
Seizure Documentation Nursing Mnemonic (TDOC)