A child is admitted with a diagnosis of early localized Lyme ...

[Shelles]

A child is admitted with a diagnosis of early localized Lyme disease. Which clinical manifestations would the nurse expect to find on the initial assessment of this client?
 
  1. Erythema 515 cm in diameter
  2. Hyperactivity
  3. Cranial nerve palsies
  4. Fever
  5. Headache

Question 2

A nurse working in a pediatric clinic is responsible for monitoring and maintaining the vaccinations on site. Which actions are appropriate for this nurse to implement?
 
  1. Fluctuate refrigerator and freezer temperatures each day.
  2. Store vaccines in the center of the unit.
  3. Check and record the temperature of the unit twice each day.
  4. Have a plan for power outages.
  5. Place bottles of water in each unit to help keep temperatures consistent.

[eliasc0401]

Answer to Question 1

Correct Answer: 1,4,5
Rationale: Erythema, fever, and headache are signs/symptoms in the early localized stage of Lyme disease. Cranial nerve palsies are seen in the early disseminated stage of the disease. Malaise, rather than hyperactivity, is seen with this disease.

Answer to Question 2

Correct Answer: 2,3,4,5
Rationale: Appropriate interventions for the nurse to implement in order to maintain the potency of vaccines include storing the vaccines in the center of the unit, checking and recording the temperature of the storage unit twice a day, having a plan for power outages, and placing bottles of water in each unit to help keep temperatures consistent. The temperature of the refrigerator and freezer should be consistent and not fluctuate.