神经螺旋体病并发股神经损伤的护理。病例报告

M. Michalak, Grażyna Frysiak, Magdalena Kazimierska-Zając
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摘要

介绍。神经螺旋体病是一种潜伏性疾病。它经常与其他神经系统疾病混淆。当出现以下症状时可以诊断:提示神经疏螺旋体病的神经系统症状,脑脊液中多细胞增多,脑脊液中产生伯氏疏螺旋体抗体。的目标。目的:评估1例神经螺旋体病股骨神经损伤患者的健康状况并确定护理需求。病例报告。一名31岁妇女作为选择性病人被送入神经内科。根据临床表现,脑脊液检查中蛋白质和淋巴细胞水平升高,以及鞘内抗疏螺旋体抗体合成,诊断为左股神经受损的神经疏螺旋体病。通过对医疗记录的观察、访谈和分析,正确识别护理问题。使用的量表有:NRS评定量表(疼痛强度)、洛维特量表(肌肉力量评估)、医院焦虑抑郁量表问卷(HADS量表的修改版本,用于评估焦虑和抑郁)、AIS量表(评估失眠)、巴克斯量表(监测和评估静脉插管相关并发症的风险)。结论。Dorothea Orem的护理理论适用于神经螺旋体病患者。病人的主要问题是:疼痛、行动困难和智力退化。疾病及其相关治疗和住院影响生物-心理-社会恶化。整体护理管理应适应患者病情的变化。护理包括旨在消除疾病影响的活动,提供情感支持,以及关于适当康复管理和预防莱姆病的教育。(JNNN 2022; 11 (4): 174 - 179)
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Femoral Nerve Injury during Neuroborreliosis — Nursing Care. Case Report
Introduction. Neuroborreliosis is an insidious disease. It is often confused with other neurological diseases. Diagnosis is possible when the following are present: neurological symptoms indicative of neuroborreliosis, pleocytosis in CSF, and production of antibodies to Borrelia burgdorferi in CSF. Aim. To assess the health situation and determine the nursing needs of a patient with femoral nerve damage during neuroborreliosis. Case Report. A 31-year-old woman was admitted to the Department of Neurology as an elective patient. On the basis of the clinical picture, elevated levels of protein and lymphocytic cells in the examination of cerebrospinal fluid and the demonstrated intrathecal synthesis of antibodies against Borrelia diagnosed neuroborreliosis with damage to the left femoral nerve. Observation, interview, and analysis of medical records were used to identify nursing problems correctly. The scales used were: the NRS Rating Scale (pain intensity), Lovett Scale (muscle strength assessment), Hospital Anxiety and Depression Scale Questionnaire (a modified version of the HADS scale to assess anxiety and depression), AIS Scale (to assess insomnia), Baxter Scale (to monitor and assess the risk of complications associated with venous cannulation). Conclusions. Dorothea Orem’s nursing theory is appropriate for a patient with neuroborreliosis. The patient’s main problems are: experiencing pain, difficulty in movement, and mental deterioration. The disease and related treatment and hospitalization influence bio-psycho-social deterioration. Holistic nursing management should be adapted to the patient’s changing condition. Care includes activities aimed at nullifying the effects of the disease, providing emotional support, and education regarding proper rehabilitation management and prevention of Lyme disease. (JNNN 2022;11(4):174–179)
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