Toxoplasmosis Nursing Care Plans Diagnosis and Interventions
Toxoplasmosis NCLEX Review and Nursing Care Plans
Toxoplasmosis is an infection caused by a protozoan parasite called Toxoplasma gondii.
Toxoplasma is a common parasite found worldwide and it normally affects warm-blooded organisms, including humans.
This parasite is known to make cats their definitive hosts, hence explaining the presence of Toxoplasma-carrying oocysts in cats’ feces. About 60% of the world population is known to have had it.
In a healthy adult, there are usually no signs and symptoms noted.
However, complications may arise in population groups with weak immune system.
Toxoplasma can stay in the person’s body and stay dormant. In this dormant stage, the parasite does not cause any illnesses.
In the cases of immunosuppression, the parasite may reactivate, causing illnesses and complications.
Signs and Symptoms of Toxoplasmosis
Most healthy adults do not present any signs and symptoms when infected with Toxoplasma gondii.
Oftentimes, the individual is not even aware of the ongoing infection. In cases of immunosuppression, however, the following may manifest:
- Body aches
- Swollen lymph nodes
People with weak immunity can have more severe presentation when infected or reinfected with the disease, which includes:
- Poor coordination
Babies can contract toxoplasmosis through placental transfer during pregnancy.
This is called congenital toxoplasmosis. Most cases end up in stillbirth. Those who survive may have the following problems:
- Liver and spleen enlargement
- Jaundice or the yellowing of the sclera and the skin
- Eye infections
Surviving infants with congenital toxoplasmosis may not exhibit signs and symptoms until they become teenagers. This may include hearing loss, mental disability, and eye infections.
Causes of Toxoplasmosis
Toxoplasmosis is caused by Toxoplasma gondi which burrows in wild and domestic cats through which their infectious forms, oocysts, get excreted in their feces.
There are different ways for a person to contract toxoplasmosis:
- Foodborne. Humans can contract toxoplasmosis by eating undercooked meat containing infective tissue forms of the parasite T. gondii. It can also be transferred to food and therefore to humans through contaminated utensils and cutting boards. Also, drinking unpasteurized goat’s milk can cause toxoplasmosis infection.
- Zoonotic transmission. Zoonotic transmission refers to animal to human transfer of the infection. Cats play a major role in this type of transmission. Cats serve as hosts to T. gondii. They shed their oocysts through their feces, and these oocysts are microscopic and can be transferred to humans through accidental ingestion by not washing hands after cleaning the cat’s litter box, drinking water infected with oocysts, or not using gloves when gardening.
- Congenital transmission. A patient with toxoplasmosis can infect the unborn child. The patient may not present symptoms, but the unborn baby can have serious complications which can affect the nervous system and eyesight.
- Rare means of transmission. In very rare occasions, toxoplasmosis can be transmitted through organ donation and transplant, as well as in blood transfusion.
Risk factors include:
- People with HIV/AIDS, on chemotherapy, and on long-term steroids use can easily contract toxoplasmosis and get infected.
Complications of Toxoplasmosis
Again, a healthy individual is unlikely to get ill from toxoplasmosis. However, the toll is on the people with weak immune system
- Nervous system involvement. Seizures and encephalitis may occur because of toxoplasmosis. The parasite targets the nervous system especially in people with weak immunity.
- Children with congenital toxoplasmosis may end up losing their hearing, develop mental disability, and blindness.
Diagnosis of Toxoplasmosis
The diagnostic tests for toxoplasmosis include the following:
- Serologic testing – a blood test to measure the level of immunoglobulin G (IgG) can tell if a person has been infected. Immunoglobulin M (IgM) may also be tested if the time of infection needs to be determined. This is mostly appropriate to pregnant women as the time of infection is necessary to give the clinician a better understanding of the possible effects of toxoplasmosis to the unborn baby.
- Culture – tissue sample like cerebrospinal fluid may be used to observe the parasite through culture. However, this method is not commonly done as the sample is not easily obtained.
- Amniotic fluid testing – to check for the presence of the parasite’s DNA. This is particularly helpful in pregnant women with toxoplasmosis.
- Imaging – ultrasound can be performed in pregnant women. It will not definitely diagnose toxoplasmosis, but it will give clinicians a visual of the baby’s brain for the presence of hydrocephalus. Magnetic Resonance Imaging (MRI) may also be performed to get images of the brain if nervous system involvement is suspected.
- Brain biopsy – if the individual is not responding to treatment, a brain biopsy is performed to check for toxoplasmosis cysts.
Treatment of Toxoplasmosis
In most cases, treatment for toxoplasmosis is not necessary. A healthy individual most often do not exhibit signs and symptoms. The doctor may prescribe the following:
- Pyrimethamine. This drug is typically used for malaria. It is a folic acid antagonist, and it prevents the body from absorbing folate.
- Sulfadiazine. It is commonly prescribed together with pyrimethamine to treat toxoplasmosis.
In pregnant women, treatment may also be given. However, the parasite is not completely eliminated and stays in the body in an inactive form.
Nursing Diagnosis for Toxoplasmosis
Nursing Care Plan for Toxoplasmosis 1
Nursing Diagnosis: Hyperthermia related to parasitic infection secondary to toxoplasmosis, as evidenced by temperature of 38.5 degrees Celsius, rapid and shallow breathing, flushed skin, profuse sweating, and weak pulse.
Desired Outcome: Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range.
|Toxoplasmosis Nursing Interventions||Rationales|
|Assess the patient’s vital signs at least every 4 hours.||To assist in creating an accurate diagnosis and monitor effectiveness of medical treatment, particularly the toxoplasmosis drugs and fever-reducing drugs administered.|
|Remove excessive clothing, blankets and linens. Adjust the room temperature.||To regulate the temperature of the environment and make it more comfortable for the patient.|
|Administer the prescribed antibiotic and anti-pyretic medications.||Use the toxoplasmosis drugs sulfadiazine and pyrimethamine to treat toxoplasmosis, which is the underlying cause of the patient’s hyperthermia. Use the fever-reducing medication to stimulate the hypothalamus and normalize the body temperature.|
|Offer a tepid sponge bath.||To facilitate the body in cooling down and to provide comfort.|
|Elevate the head of the bed.||Head elevation helps improve the expansion of the lungs, enabling the patient to breathe more effectively.|
Nursing Care Plan for Toxoplasmosis 2
Nursing Diagnosis: Deficient Knowledge related to new diagnosis of toxoplasmosis as evidenced by patient’s verbalization of “I want to know more about my diagnosis and care”
Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of toxoplasmosis and its management.
|Toxoplasmosis Nursing Interventions||Rationales|
|Assess the patient’s readiness to learn, misconceptions, and blocks to learning (e.g. denial of diagnosis or poor lifestyle habits)To address the patient’s cognition and mental status towards the new diagnosis of toxoplasmosis and to help the patient overcome blocks to learning.|
|Explain what toxoplasmosis is, and how it affects the vital organs such as the nervous system. Avoid using medical jargons and explain in layman’s terms.||To provide information on toxoplasmosis and its pathophysiology in the simplest way possible.|
|Inform the caregiver the details about the prescribed medications (e.g. drug class, use, benefits, side effects, and risks) for the treatment and symptomatic relief of toxoplasmosis.||To inform the patient of each prescribed drug and to ensure that the patient fully understands the purpose, possible side effects, adverse events, and administration details.|
|Explain to the patient what serologic testing is.||Serologic testing is a blood test to measure the level of immunoglobulin G (IgG) can tell if a person has been infected. Immunoglobulin M (IgM) may also be tested if the time of infection needs to be determined. This is mostly appropriate to pregnant women as the time of infection is necessary to give the clinician a better understanding of the possible effects of toxoplasmosis to the unborn baby.|
Nursing Care Plan for Toxoplasmosis 3
Desired Outcome: The adult patient will demonstration active participation in necessary and desired activities and demonstrate increase in activity levels.
|Toxoplasmosis Nursing Interventions||Rationales|
|Assess the patient’s degree of fatigability by asking to rate his/her fatigue level (mild, moderate, or severe). Explore activities of daily living, as well as actual and perceived limitations to physical activity. Ask for any form of exercise that he/she used to do or wants to try.||To create a baseline of activity levels, degree of fatigability, and mental status related to fatigue and activity intolerance.|
|Encourage progressive activity through self-care and exercise as tolerated. Explain the need to reduce sedentary activities such as watching television and using social media in long periods. Alternate periods of physical activity with rest and sleep.||To gradually increase the patient’s tolerance to physical activity.|
|Teach deep breathing exercises and relaxation techniques. Provide adequate ventilation in the room.||To allow the patient to relax while at rest. To allow enough oxygenation in the room.|
|Refer the patient to physiotherapy / occupational therapy team as required.||To provide a more specialized care for the patient in terms of helping him/her build confidence in increasing daily physical activity.|
More Toxoplasmosis Nursing Diagnosis
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
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