NSG 3600 EXAM 4 Integumentary
1. Determine the S/S, teaching, and safe patient-centered nursing care using
evidence based practice for the pediatric patient w/ tissue integrity
problem such as:
Pediculosis Capitus
• Commonly known as “head lice”; is common childhood condition that can be
passed among friends and family
• 3 types of lice: scalp, body, and pubic
• Lice pierce the skin and suck blood; bites can cause severe itching and
can predispose child to a secondary infection
• S/S:
o Live Lice: tend to live near the nape of the neck and behind the ears
o Louse eggs (Nits): along the shaft of the hair (the older the nits, the more
distal), pearlescent teardrop in shape, initially laid at the base of hair
shaft. Fluoresce blue under a Wood’s lamp.
o Nits on the eyelashes of child are sometimes s/s of sexual abuse; report
suspicious findings
• DX:
o Clinical presentation and ID of the louse and/or it’s eggs is important
o Persistent itching is a classic sign
• Prevention:
o Avoid use of one another’s combs, barrettes, hats, and headbands
o Children involved in sports may pass lice through helmet sharing
and headgear sharing
o EVERYONE NEEDS TO BE TREATED
• Nursing Care:
o Assess child’s hair at school
o TX: Malathion (Ovide) recommended for kids > 2
o Benzoyl not recommended for < 6 months
o Permethrin (Nix) not recommended < 2 months
o Spinosad not proven safety in kids < 4 yrs
• Education:
o Wash hair according to products instructions
▪ If child can’t tolerate, use of petroleum and food oils (olive oil) can
be used
, o Once shampoo is rinsed, remove nits by back combing w/ fine tooth comb
while hair is still wet
o Implement house cleaning (dust, vacuum, and scrub); wash clothing and
bedding; wipe off hats, helmets, and toys
o Stuffed animal bagged in a sealed plastic bag away from family for 14 days
o Launder ALL bed linens in hot water
o Pillows washed if possible, or thrown away if used by child
o Anti-lice sprays on furniture and other environmental objects that are
not disposable
o Hair are items can be boiled (hot water above 140 degrees) or soaked
in anti-lice shampoo and never shared
o Remove nits from eyelashes by applying petroleum jelly to the eyelashes
twice a day for 8 days
o Check schools “anti-lice” policy; child must remain home from school until
lice free
o Child MUST be required to be checked by school nurse or day-care
provider before returning
o Child rechecked for infestation in 7-10 days; sooner if child is itching
incessantly or itching interferes w/ sleep
Tinea Corporis
• Involves the skin of the body , is characterized by a round to oval lesion w/
maculopapular border w/ central clearing often w/ scaling , except the
scalp, groin, hands, and feet
• Referred to the common term “ringworm” even though no worm is involved
• DX:
o Visual inspection using Wood’s lamp
o Potassium hydroxide preparation of scrapings
• Prevention:
o Check family pets
o Good hand hygiene
o Bathe after sports
o DO NOT share towels, combs, hats, helmets, and intimate apparel
(Fomites- objects carrying infection)
• Nursing Care:
o EVERYONE NEEDS TO BE TREATED
o Antifungals: Griseofulvin, Fluconazole, Miconazole, Terbinafine
1. Determine the S/S, teaching, and safe patient-centered nursing care using
evidence based practice for the pediatric patient w/ tissue integrity
problem such as:
Pediculosis Capitus
• Commonly known as “head lice”; is common childhood condition that can be
passed among friends and family
• 3 types of lice: scalp, body, and pubic
• Lice pierce the skin and suck blood; bites can cause severe itching and
can predispose child to a secondary infection
• S/S:
o Live Lice: tend to live near the nape of the neck and behind the ears
o Louse eggs (Nits): along the shaft of the hair (the older the nits, the more
distal), pearlescent teardrop in shape, initially laid at the base of hair
shaft. Fluoresce blue under a Wood’s lamp.
o Nits on the eyelashes of child are sometimes s/s of sexual abuse; report
suspicious findings
• DX:
o Clinical presentation and ID of the louse and/or it’s eggs is important
o Persistent itching is a classic sign
• Prevention:
o Avoid use of one another’s combs, barrettes, hats, and headbands
o Children involved in sports may pass lice through helmet sharing
and headgear sharing
o EVERYONE NEEDS TO BE TREATED
• Nursing Care:
o Assess child’s hair at school
o TX: Malathion (Ovide) recommended for kids > 2
o Benzoyl not recommended for < 6 months
o Permethrin (Nix) not recommended < 2 months
o Spinosad not proven safety in kids < 4 yrs
• Education:
o Wash hair according to products instructions
▪ If child can’t tolerate, use of petroleum and food oils (olive oil) can
be used
, o Once shampoo is rinsed, remove nits by back combing w/ fine tooth comb
while hair is still wet
o Implement house cleaning (dust, vacuum, and scrub); wash clothing and
bedding; wipe off hats, helmets, and toys
o Stuffed animal bagged in a sealed plastic bag away from family for 14 days
o Launder ALL bed linens in hot water
o Pillows washed if possible, or thrown away if used by child
o Anti-lice sprays on furniture and other environmental objects that are
not disposable
o Hair are items can be boiled (hot water above 140 degrees) or soaked
in anti-lice shampoo and never shared
o Remove nits from eyelashes by applying petroleum jelly to the eyelashes
twice a day for 8 days
o Check schools “anti-lice” policy; child must remain home from school until
lice free
o Child MUST be required to be checked by school nurse or day-care
provider before returning
o Child rechecked for infestation in 7-10 days; sooner if child is itching
incessantly or itching interferes w/ sleep
Tinea Corporis
• Involves the skin of the body , is characterized by a round to oval lesion w/
maculopapular border w/ central clearing often w/ scaling , except the
scalp, groin, hands, and feet
• Referred to the common term “ringworm” even though no worm is involved
• DX:
o Visual inspection using Wood’s lamp
o Potassium hydroxide preparation of scrapings
• Prevention:
o Check family pets
o Good hand hygiene
o Bathe after sports
o DO NOT share towels, combs, hats, helmets, and intimate apparel
(Fomites- objects carrying infection)
• Nursing Care:
o EVERYONE NEEDS TO BE TREATED
o Antifungals: Griseofulvin, Fluconazole, Miconazole, Terbinafine
