Head Lice - case study PDF

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Case Study – Head Lice Scenario A.P. is an 8-year-old who is sent to the nurse's office because she has had a 2-day history of scratching her head so badly that she complains that her “head hurts.” you complete a general examination of A.P.'s head and notice that she has red, irritated areas with several scratch marks; a few open sores; and sesame seed–sized, silvery white and yellow nodules (bugs) that are adhered to many of her hair shafts. you determine that A.P. has pediculosis capitis. 1. What is pediculosis capitis? A condition in which the head hair and the scalp is infected by the head lice, a tiny insect. Commonly found in school aged children. 2. What will be your next steps in A.P.’s care?

The next step will be to recommend a OTC treatment for the head lice infestation. Which will be a pediculicide Permethrin 1% lotion (shampoo) for the hair.

3. What should be included in the educational plans for A.P. and her parents? How to use the solution for the treatment of lice:     

Shampoo the hair and scalp using regular shampoo. Thoroughly rinse and towel dry the hair and scalp. Allow hair to air dry for a few minutes. Shake the permethrin lotion well before applying. Thoroughly wet the hair and scalp with the permethrin lotion. Be sure to cover the areas behind the ears

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and on the back of the neck also. Allow the lotion to remain in place for 10 minutes. Then, rinse the hair and scalp thoroughly and dry with a clean towel. When the hair is dry, you may want to comb the hair with a fine-toothed comb to remove any remaining nits (eggs) or nit shells.

I also will educate A.P and her parents on other steps that should be taken within in the home.   

Wash clothes and beddings in hot water (60 degrees Celsius) and dry them on high heat in the dryer Dry-clean the clothes and beddings Vacuuming of upholstered furniture and floors

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Seal clothes and beddings for a period of two weeks Soak hairbrushes, combs, barrettes, and other hair accessories in hot water (60 degrees Celsius) for 5 to 10 minutes

4. The parents take A.P. home to treat her. Which statement by A.P.'s mother would help make A.P. the most comfortable during this treatment period? Explain. a. “Here is the shampoo. Be sure to scrub your head for several minutes.” b. “We can pretend you're at the beauty parlor! Lean back while I wash your hair.” c. “I sure hope this works. I never thought this would happen!” d. “It might be best to go ahead and cut your hair. It will grow back quickly.” (B) The child must be made as comfortable as possible. Playing "beauty parlor" can make the time more pleasant since the shampoo must stay on the scalp for 10 minutes. The parent being able to assist the child with the treatment will ensure that the treatment is being done correctly. 5. Why would head lice occur in school-aged children? The main way head lice spread is from close head-to-head contact with an infected person. In school age children it is so easily spread because of the close contact between the children. This contact can take place during play, school, sports activities and at school, home, slumber parties or camp.

6. What possible complications can occur as a result of failing to treat head lice? If head lice are left untreated it can lead to infection, blood loss and iron deficiency anemia, allergic reaction to the lice feces and or bites. Infection: frequent scratching can cause breaks in the skin that can leave you vulnerable to infection Iron deficiency anemia/ blood loss: lice feed on human blood, severe, chronic infestations can lead to these conditions. Allergic reaction: feces or bites may trigger a rash in some individuals

7. What nursing actions would you take regarding A.P.'s classmates? All classmates will need to be assessed for head lice, so that appropriate therapy begun as soon as possible. The parents of the classmates should be notified about the situation. Educational materials regarding the situation and lice should be sent home for students and parents. The information should provide how lice are spread, and what the parents can do to prevent an infestation of lice from occurring. Prevention can start with no sharing of personal items such as combs, brushes, or hats, for this is a great way to spread lice.

8. A.P.'s mother calls you to ask what complications may occur with the head lice infestation. Which answer is correct? a. “Head lice may transmit certain viral illnesses.” b. “Head lice are not known to transmit disease.” c. “Head lice are common carriers of impetigo.” d. “It is common to have a ringworm infection after a case of head lice.” (B) I will inform A.P mother that head lice are not known to carry diseases, but secondary bacterial infection of the skin may occur as a result from scratching. Case Study Progress Ten days later, A.P.'s mother calls you and states, “I think she has lice again! We worked so hard to get rid of them and clean everything. Is there something else we can use to treat her? What do we do now?” 9. What would you tell A.P.'s mother at this time? Reassure A.P mother that relapses may occur despite her best efforts. Ask and review with her what she did to treat the lice infestation including how and what she did to clean the home. Advise her to repeat the treatment and emphasize how important it is to treat all items that A.P. has contacted by washing and drying using the hot water and hot air cycles. If she feels that using the same shampoo is not enough, I will encourage her to reach out to A. P’s doctor for something a little stronger. I will also encourage her to look on the CDC website for additional information on what lice are what can be done to treat and prevent them....