Download outline tissue integrity (1)

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