Maryville NURS 623 Exam 1 (2022/2023) Already Graded A

Maryville NURS 623 Exam 1 (2022/2023) Already Graded A What is scabies? -A highly contagious mite infestation Risk factors of scabies -Overcrowding -Conditions of poverty -Poor hygiene, malnutrition What is the mode of transmission for scabies? -Close personal contact Subjective symptoms for scabies -Itching, worse at night and often does not respond to treatment -Some will have rash, some will not -Children may be irritable and have changes in feeding -Close contacts may have similar symptoms What are common areas for scabies infection? -Webs of fingers -Wrists -Axillary folds -Periumbilical -Pelvic girdle -Penis -Ankles Objective symptoms for scabies -Early sign: small 1-2mm red papules -Excoriation from itching, crusting, scaling -Intraepidermal burrows, lichenification -Burrows will be white with black specks Diagnostic tests for scabies -Burrow Ink Test: where excess ink will concentrate in the mite tunnel -Burrow scraping Management of scabies -Whole household needs to be treated -Permethrin 5% cream leave on for 8-12 hours, rinse off, repeat in 1 week -Ivermectin 200mcg/kg x 1 and then repeat in 1-2 weeks in conjunction with topical cream -Antihistamines, topical steroids for itching (triamcinolone 0.1% BID x 7 days) -If concurrent bacterial infection then Dicloxacillin or Cephalexin for 7-10 days Follow-up for scabies -1 week following initial treatment -Derm referral for consistent scabetic nodules of crustosa Patient education for scabies -Trim fingernails to prevent re-infestation -Do not exceed recommended exposure time for creams -Itching can continue for up to 1 week -Wash bed sheets and clothing in hot soapy water Risk factors for lice (pediculosis) -School-age children -Homeless, crowded conditions Mode of transmission for lice -Close personal contact Subjective symptoms of lice -Intense itching in areas of the body preferred by the lice type -Itching worse at night -Children may be restless, irritable, trouble concentrating Objective findings of lice -Small 2-3mm red macules/papules that are itchy -Hive like reaction in some patients -Excoriation on scalp from itching -Nits found on hair shafts -Lice are 6 legged wingless insects Management of lice -Treat patient and close contacts -Shampoo/creams/rinses containing benzyl alcohol, Ivermectin, Permethrin, spinosad are commonly used -Manual delousing and nit removal using fine toothed comb -Petroleum jelly, mayo/tea tree oil/olive oil left on overnight with showercap -Secondary bacterial treatment use Dicloxacillin or Cephalexin for 7-10 days Follow-up for lice -Uncomplicated infestations do not require follow-up -Follow-up in 1 week if symptoms persist Patient education for lice -Do not share hats, combs, scarves, towels, or bedding -Combs and brushes should be washed in hot, soapy water and air dry -When using shampoo: do not exceed exposure time, rinse over the sink -Itching can continue for up to 1 week -Do not need to treat pets -Bedclothes and sheets should be washed in hot soapy water and dried in a hot dryer, vacuum carpets/upholstery -Children can return to school after treatment, screen weekly