ediculosis.

Infestation by lice, involves three different parasites:

Pediculosis humanus capitis (head louse)

Pediculosis humanus corporis (body louse)
Phthirus pubis (pubic or crab louse)

Scabies
Involves infestation by the itch mite, Sarcoptes scabiei.
Pathophysiology
Pediculosis
Lice live on the hosts skin surface and depend on the host for nourishment, feeding on
human blood approximately five times daily. They inject their digestive juices and
excrement into the hosts skin and lay their eggs (i.e. nits) on hair shafts.
Scabies
Adult itch mites burrow into the superficial layer of skin and lay two to three eggs daily for
up to 2 months. Eggs hatch in 3 to 4 days, clinical symptoms are related to a sensitivity
reaction as larvae emerge to the skin surface.
Assessment/Clinical Manifestations/Signs and Symptoms
Pediculosis
Itching
Excoriation from scratching
Possibly, small, red papules in infected areas.
Tiny, gray-white nits on hair shafts
Scabies
 Severe itching
Excoriated lesions possibly appearing as erythematous nodules
Possible secondary bacterial infection
Medical Management
Pediculosis capitis: treatment involves the hair with a shampoo containing lindane (Kwell)
or pyrethrin compounds with piperonyl butoxide (RID or R&C Shampoo). The patient is
instructed to shampoo the scalp and hair according to the product directions.
Pediculosis corporis and pubis: the patient is instructed to bathe with soap and water, after
which lindane (Kwell) or 5% permetrhin (Elimite) is applied to affected areas of the skin
and to hair areas, according to the product directions. An alternative topical therapy is an
over-the-counter strength of permethrin (1% Nix)
Scabies: A prescription scabidie such as lindane (Kwell), crotamiton (Eurax), or 5%
permethrin (Elimite) is applied thinly to entire skin from the neck down, spatting only the
face and scalp (which are not affected in scabies). The medication is left on for 12 to 24
hours, after which the patient is instructed to wash thoroughly. One application may be
curative, but it is advisable to repeat the treatment in 1 week.
Nursing Diagnosis
Deficient knowledge about the disease process and treatment
Impaired skin integrity related to lesions and inflammatory response
Disturbed body image related to embarrassment over appearance and self-perception of
uncleanliness
Nursing Management
1. Provide general nursing care for parasitic skin diseases, which focuses on enhancing skin
integrity, providing pain relief, preventing infection and providing client and family
teaching.
2. Provide client and family teaching regarding measures to treat pediculosis.
Teach the client with lice (or a parent if the client is a child) to shampoo with lindane
and remove nits with a fine-tooth comb.
3. Provide client and family teaching regarding measures to treat scabies.
Teach the client how to use a scabicide, such as lindane or crotamiton.
Explain that the scabicide is directly absorbed by the parasites.
Instruct the client to wash scaling debris or crusts with warm, soapy water and dry the
area thoroughly before applying medication.
Leave the medication on for 12 to 24 hours and then wash thoroughly.
4. Teach precautions to prevent future infestations.
Wash all bedding and clothing in hot water and dry it using the hot cycle of the clothes
dryer.
Never share hair brushes, combs or hats

5. kinParasites
6. 1. Scabies
7. It is a contagious skin disease, caused by the female itch mite (Acarus Scabiei).This
parasite burrows itself in the skin for the purpose of depositing eggs. It is
easilytransferred from person to person.
8. Clinical Manifestation:
9.
10. Parts of body involved are those in which skin is thin and moist, i.e.
axilla, wrists,between fingers and toes, around abdomen and genitalia. In infants it may
occur any where in body.
11.
12. The lesion appears as dark blue lines indicating the path used by the itch mite toburrow
itself, the color is due to its fecal deposits.
13.
14. Severe itching.
15.
16. Secondary infections with papules, vesicles and pustules.
17. Treatment and Nursing Care:
18. This aims at: 1. Killing parasite. 2. Relieving itching.
19. Specific Treatment:
20. Various preparations containing D.D.T. powder as: Benzyl benzoate, BenzneHexachloride 33%.1.A
prolonged hot bath followed by 2-3 applications of any of these
preparations,each one every 12 hrs. Twelve other hours after last application, another
hotbath is taken. This is usually enough to get rid of infestation.2.If this is not
available, old fashion sulphur- ointment 5% may be used.3.Broad-spectrum
antibiotics to combat secondary infection.4 . C u t n a i l s a n d p r e v e n t
s c r a t c h i n g . 5.It is important to discover all infected persons in the house
hold and treat themsimultaneously in order to kill the mites, and prevent return of
disturbance.6.All clothes must be dry cleaned or boiled.
21. 2. Pediculosis
22. It is the infestation of child with pediculi (lice).There are three types:
23. 1.
24. Pediculosis Capitis
25. (of hair).
26. 2.
27. Pediculosis Pubic:
28. pubic, in old people, in eyelashes or eyebrows inyounger children.
29. 3.
30. Pediculosis Corporis
31. (of body).Each type is caused by a different louse.
32. Pediculosis Capitis:
33.

34.
35. Infestation of scalp, hair and occasionally eyelashes and eyelashes withpediculosis of
hair. The lice dwell on the scalp, but deposit eggs or nits on shafts of hair: these are
small oval, white greyish and can be seen by naked eyes.
36. Incidence:
37. Common in neglected, unclean children, easily transferred from child to child
inschoolroom or in overcrowded houses. More common in females (long hair).
38. Clinical Manifestations:
39. 1.Severe itching of scalp, there is slight errythema and purpuric spots at site
of attachment to scalp scratching them leads to excoriation, with serous, or sanguinous
exudates. Crusts form.2 . E x c o r i a t i o n o f f a c e a n d n e c k . 3.Posterior cervical
lymph glands become enlarged and infected f rom scalplesions.4 . P y o g e n i c
bacteria may infect scalp.
40. Treatment and Nursing Care:
41. It aims at: 1. Killing pediculi. 2. Killing nits. 3. Bringing relief tochild.Modern treatment is
effective and similar to treatment of scabies.
42.
43. Various preparations containing DDT powder (Benzyl 2% Benzoate) ect in formof two
applications about 12 hours apart is usually enough. Or repeat as often asneeded. It is
better to cover childs head. Recently, there have been specificshampoo
(Hexachlorogamabenzen). The childs head is washed for minutes. Thisis then repeated
after 24 hours. Followed by fine combing of hair with fine comb.
44.
45. Nits are destroyed by combing hair with fine toothcomb dipped in hot vinegar.
46.
47. If hair is heavily infested, cut hair close to scalp.
48.
49. Clothes and heads covering should be dry cleaned or boiled and ironed.
50.
51. They must be dusted with 10% DDT.
52.
53. Antibiotics, if pustules appear on face and neck.
54.
55. Children should be cautioned not to exchange hat or comb with other children.
56.
57. Treat remained of family If infested
58. Nursing Care Plan for Child with Pediculosis Capitis:Nursing Diagnosis:
59. Potential impaired skin integrity related to insect bites, scratching.
60. Patient Goal:
61. Eradicate lice and nits.
62. Nursing Interventions:
63.
64. Apply, or teach family to apply, pediculicide shampoo or rinse.
65.
66. Read directions several times in quite environment before application.
 67.
68. Make child as comfortable as possible during procedure.
69.
70. Playing beauty parlor adds a dimension of fun as well as providing eye safety.
71.
72. Use plastic drape to prevent drug getting on other body parts.
73.
74. Instruct child to shut eyes tightly during application; if irritation occurs, flush wellwith
tepid water.
75.
76. Dont use hair dryer.
77.
78. Use fine toothcomb on dry or slightly damp hair to remove empty nit cases.
79.
80. Stress importance of second application of pediculicide or shampoo.
81.
82. Contact community agencies for suggestions for reducing epidemics.
83. Expected Outcome:
84. Child does not become infected with organism.
85. Nursing Diagnosis:
86. Body image disturbance related to infestation.
87. Patient Goal:
88. Reassure child and family.
89. Nursing Interventions:
90.
91. Launder washable items of clothing and linens in hot water and dry in dryer or
hotsetting for at least 20 minutes.
92.
93. Soak combs, brushes, and other hair utensils in pediculicide shampoo or lotionfor 1 hour
or in boiling water for 10 minutes (some advocate placing non-washable, non-cleanable
items in a tightly closed plastic bag that remains sealedfor 14 days).
94.
95. Vacuum mattresses and upholstered furniture carefully; pediculosis sprays
arenot recommended.
96. Expected Outcome:
97. Inspection of scalp reveals no evidence of lice or nits.
98. Goal 2:
99. Prevent infestation/ reinfestation.
100. Nursing Interventions:
101.
Caution children against sharing combs, hats, caps, scarves, coats, or other items used on
or near the hairA communicable disease of the skin caused by Sarcopte Scabiei and
characterized by the eruptive lesions produced from the burrowing of the parasite into the
skin.
Etiologic Agent
1. The mite is yellowish-white and can barely be seen by unaided eye.
2. The female parasite burrows beneath the epidermis to lay her eggs and sets up an intense
irritation.
3. The males are smaller and reside at the surface of the skin.
4. Scabies occurs worldwide, and is predisposed by overcrowding and poor hygiene.
Incubation
It occurs within 24 hours from the original contact, the length of time required from itch
mite to (burrow) or infected skin lay ova.
Period of Communicability
The disease is communicable for the entire period that the host is infected.
Signs and Symptoms
1. Itching
2. When secondarily infected the skin may feel hot and burning but this is a minor
discomfort.
3. When large areas are involved and secondary infection is severe there will be fever,
headache and malaise. Secondary dermatitis is common.
Mode of Transmission
1. The disease is transmitted by direct transmission of infected individuals.
2. The disease is also be transmitted through sleeping in an infected bed or wearing infected
clothing.
3. Anyone may become infected or re-infected.
4. Infestation with mites may also result from contact with dogs, cats, and small animals.
Pathology
1. The female mite burrows into the skin to lay her eggs, from which larvae emerge to
copulate and re-burrow under the skin.
2. While any part of the body maybe infected, the itch mite maybe found in the interdigital
spaces of the fingers or in warm folds in the skin.
3. Areas of friction, such as the crotch, axillae, or the belt line, around the nipple in women
and the periumbilical region are sites of predilection.
4. The external genitalia are most frequently involved in adult males.
5. The lesions are slightly elevated, straight or twitching burrows, thread like that are either
brown or black in color, that are about 5 to 6 mm in length.
6. Severe inflammation with the development of the papules, blisters, pustules, and crusts
may come as a result of infection from scratching.
7. In infants, burrows may appear on the head or neck.
8. The disease may become fully developed into two weeks; the eggs hatch in about 6 days,
and the parasite grows very rapidly. It may persist for month or even years if not
recognized or properly treated.
Diagnosis
1. Appearance of lesion, and intense itching and finding of the causative mite.
2. Scraping from its burrow with a hypodermic needle or curette, and then examined under
low power of the microscope or by hard lens.
Treatment
 1. The whole family should be examined before undertaking treatment, as long as a member
of family remains infected, other members will get the disease
2. Treatment for scabies consists of application of pediculicide, like permethrin cream of
lindane lotion in thin layer over the entire skin surface and is left for ten to twelve (10-12)
hours.
3. Crotamiton cream applied for five consecutive nights.
4. Neosporin ointment rubbed into the affected skin four to five times a day.
5. Eurax and kwell lotion also prove effective to some patients.
6. All clothes used before and during the treatment period should be disinfected by dry
cleaning or boiling.
Nursing Interventions
1. Instruct patient to apply the cream at bedtime, from neck down to toes, covering the
entire body.
2. Advise patient to report any skin irritation.
3. Suggest the family members and other close contact of the patient be checked for possible
symptoms and be treated if necessary.
4. If patient is hospitalized, practice good handwashing technique, or use gloves while
performing nursing procedure.
5. Terminal disinfection should be carried out after discharge of patient.
Prevention and Control
1. Good personal hygiene daily bath; washing the hands before and after eating, and after
using the toilet; cutting off fingernails.
2. Regular changing of clean clothing beddings and towels.
3. Eating the right kind of food like rich in Vitamin A and Vitamin C such as green leafy
vegetable and plenty of fruits and fluids.
4. Keeping the house clean.
5. Improving the sanitation of the surrounding
102.
min C such as green leafy vegetable and plenty of fruits and fluids

Scabies, previously known as the seven-year itch, is a contagious skin infestation by

the mite Sarcoptes scabiei.[ and characterized by the eruptive lesions produced from the
burrowing of the parasite into the skin.

Etiologic Agent
1. Scabies is caused by infection with the female mite Sarcoptes scabiei var. hominis
2. The mite is yellowish-white and can barely be seen by unaided eye.
3. The female parasite burrows beneath the epidermis to lay her eggs and sets up an
intense irritation.
4. The males are smaller and reside at the surface of the skin.
5. Scabies occurs worldwide, and is predisposed by overcrowding and poor hygiene
6. it occurs within 24 hours from the original contact, the length of time required from itch
mite to (burrow) or infected skin lay ova.
Period of Communicability
 The disease is communicable for the entire period that the host is infected.
Signs and Symptoms

1. Parts of body involved are those in which skin is thin and moist, i.e. axilla, wrists,
between fingers and toes, around abdomen and genitalia. In infants it may occur any
where in body.
2. The lesion appears as dark blue lines indicating the path used by the itch mite toburrow
itself, the color is due to its fecal deposits.
3. Severe itching.
4. Secondary infections with papules, vesicles and pustules
5. When secondarily infected the skin may feel hot and burning but this is a minor
discomfort.
6. When large areas are involved and secondary infection is severe there will be fever,
headache and malaise. Secondary dermatitis is common.

Mode of Transmission
1. The disease is transmitted by direct transmission of infected individuals.
2. The disease is also be transmitted through sleeping in an infected bed or wearing infected
clothing.
3. Anyone may become infected or re-infected.
4. Infestation with mites may also result from contact with dogs, cats, and small animals.
Pathology
1. The female mite burrows into the skin to lay her eggs, from which larvae emerge to
copulate and re-burrow under the skin.
2. While any part of the body maybe infected, the itch mite maybe found in the interdigital
spaces of the fingers or in warm folds in the skin.
3. Areas of friction, such as the crotch, axillae, or the belt line, around the nipple in women
and the periumbilical region are sites of predilection.
4. The external genitalia are most frequently involved in adult males.
5. The lesions are slightly elevated, straight or twitching burrows, thread like that are either
brown or black in color, that are about 5 to 6 mm in length.
6. Severe inflammation with the development of the papules, blisters, pustules, and crusts
may come as a result of infection from scratching.
Diagnosis
1. Appearance of lesion, and intense itching and finding of the causative mite.
2. Scraping from its burrow with a hypodermic needle or curette, and then examined under
low power of the microscope or by hard lens.
Treatment
1. The whole family should be examined before undertaking treatment, as long as a member
of family remains infected, other members will get the disease
 2. Treatment for scabies consists of application of pediculicide, like permethrin cream of
lindane lotion in thin layer over the entire skin surface and is left for ten to twelve (10-12)
hours.
3. Crotamiton cream applied for five consecutive nights.
4. Neosporin ointment rubbed into the affected skin four to five times a day.
5. Eurax and kwell lotion also prove effective to some patients.
6. All clothes used before and during the treatment period should be disinfected by dry
cleaning or boiling.
Nursing Interventions
1. Instruct patient to apply the cream at bedtime, from neck down to toes, covering the
entire body.
2. Advise patient to report any skin irritation.
3. Suggest the family members and other close contact of the patient be checked for possible
symptoms and be treated if necessary.
4. If patient is hospitalized, practice good handwashing technique, or use gloves while
performing nursing procedure.
5. Terminal disinfection should be carried out after discharge of patient.
Prevention and Control
1. Good personal hygiene daily bath; washing the hands before and after eating, and after
using the toilet; cutting off fingernails.
2. Regular changing of clean clothing beddings and towels.
3. Eating the right kind of food like rich in Vitamin A and Vitamin C such as green leafy
vegetable and plenty of fruits and fluids.
4. Keeping the house clean.
5. Improving the sanitation of the surroundings