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Amanda Salazar Iris Urittia Erica Reyes Vanessa Silva Melissa Gutierrez All Mc Pherson Tissue Integrity Presentation Phthirus Pubis Outline Risk factors Those who live in close quarters. Transmitted chiefly by sexual contact; Infestation by pubic lice may coexist with sexually transmitted infections (STI) such as gonorrhea, herpes, or syphilis. Sharing of underwear, bathing suits, blankets that are infested with pubic lice. Physiological process (Signs and symptoms) Genital itching (most frequent during the night). Reddish-brown dust (i.e., excretions of the insects) may be found in the patient’s underclothing. Visible nits or crawling lice. (Definition) Phthirus pubis is an infestation of the body by body louse; pubic louse is a lice infest also known as “crabs” which is extremely common, lice are called ectoparasites because they live on the outside of their host’s body. They depend on the host for their nourishment, this feeding off of the human occurs approximately five times each day. The severe itching patients experience are the injection of the lice’s digestive juices and excrement into the skin. The infestation is generally localized in genital region and is transmitted primarily by sexual contact. Infestation by pubic lice may coexist with sexually transmitted infections (STI) such as gonorrhea, herpes, or syphilis. Lice can also occur on the chest hair, axillae, beard, and eyelashes. Assessment During the examination of the client, remember these key points: Make sure to have a chaperone in the room while performing the examination. Wash hands and Wear disposable gloves. Prepare the client thoroughly for the physical examination to put the client at the greatest ease. Perform the examination professionally and preserve the client’s modesty and provide privacy. As you begin the examination, note the distribution of pubic hair. Also be alert for signs of infestation. The pubic area should be examined with a magnifying glass for lice crawling down a hair shaft or nits cemented to the hair or at the junction with the skin. With males: infestation at the base of the penis and within the pubic hair. Lice or nits (eggs) at the base of the pubic hairs indicate infestation. Persons infected with pubic lice should also be examined for the presence of other sexually transmitted diseases. Collaborative interventions Wash hair with shampoo that contains pyrethrin compounds with piperonyl buoxide (RID or R&C Shampoo) Malathion (Ovide). You apply this prescription lotion to the affected area and wash it off after eight to 12 hours. Ivermectin (Stromectol). This medication is taken as a single dose of two pills, with an option to take another dose in 10 days if the treatment isn't initially successful. Eye treatments. If pubic lice are found in eyelashes, you can treat them by applying petroleum jelly to your eyelid and lashes three times a day for several days. In addition, or as an alternative, the lice and nits can be gently removed from eyelashes using tweezers, a nit comb or your fingernails. Your doctor may also prescribe a medicine to apply to the eyelids. Clean clothing and underwear should be put on after treatment. Towels, clothing, and bedding used within 2-3 days before treatment should be machine-washed in water of at least 130 deg F. And dried in a hot dryer Items that cannot be laundered should be dry-cleaned or stored in a sealed plastic bag for 2 weeks. Interrelated concepts/Use of concept analysis diagram ((Included in attachment)) Nursing diagnosis Actual nursing diagnosis: Impaired skin integrity related to excretion into the skin and skin contact with proboscis secondary to Phthirus pubis as manifested by severe itching, bleeding, and scratch marks. Goal: The patient will show improved skin integrity as manifested by no signs of itching, bleeding, or scratch marks within one-two weeks. Risk nursing diagnosis: Risk for infection related to broken skin secondary to scratching due to phthirus pubis. Goal: The patient will remain free of infection as evidence by intact skin and normal color of skin Audience participation Post test with game and prizes Resources Ralph, S., & Taylor, C. (2011). Sparks & Taylor's nursing diagnosis reference manual (8th ed., p. 214, 370). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Brunner, L. (2008). Brunner & Suddarth's textbook of medical-surgical nursing (11th ed., p. 1783). Philadelphia: Lippincott Williams & Wilkins. Weber, J., & Kelley, J. (n.d.). Health assessment in nursing (Fifth ed., p. 593). ‘Pediculosis and Pthiriasis (Lice Infestation) Treatment & Management”, Guenther, Lyn C C , MD, FRCPC, FAAD Medical Director, The Guenther Dermatology Research Centre; President, Guenther Research, Inc; Professor, Department of Medicine, Division of Dermatology, Western University, Canada, 09,FEBURARY 2015. Web retrieval 11/15/15 <http://emedicine.medscape.com/article/225013-treatment#d17> Member participation Iris wrote the nursing diagnosis’; Vanessa researched the definition, concept map, and interrelated concepts; Erica researched the risk factors, signs and symptoms, and assessment; Amanda wrote the outline made the power point and the game; Melissa researched the treatment and patient education