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( can these notes/terms be written so its in complete sentences where a group of high school students can understand them) Bites, Stings, & Irritants 1. Lice (Pediculosis capitis) Lice is an infestation of the scalp by Pediculus humanus capitis (head lice) that spreads through direct contact with infested individuals or objects (hats, brushes). Findings Intense pruritus (excessive scratching of the scalp) and visible nits (white eggs) on the hair and scalp (FIGURE 1) FIGURE 1. HEAD LICE NITS & ADULT LICE Nursing interventions ⮹ If hospitalized, initiate contact isolation precautions. Apply permethrin 1% cream (pediculicide) to the client’s washed hair, leave for several minutes, then rinse. ⮹ Manually remove nits using a fine-tooth comb. ⮹ Provide client teaching: Wash all clothing and bedding in hot water and dry on high heat to kill nits. ⮹ Seal non-washable items in plastic bags for 2 weeks. ⮹ Vacuum furniture, carpets, and car seats. Avoid sharing personal items, such as brushes or hats. ⮹ Close contacts (family members, classmates) should be examined for lice. Lice and scabies treatment: Lice is treated with permethrin hair cream (pediculicide). Scabies is treated with permethrin cream (scabicide) applied to the entire body. 2. Scabies Scabies is an infestation of the skin by the mite Sarcoptes scabiei that spreads through close personal contact. Findings ⮹ Rash with intense pruritus, especially at night Borrow tracks (grayish thread-like lines) (FIGURE 2) FIGURE 2. SCABIES BURROW TRACKS Integumentary Nursing Interventions ⮹ If hospitalized, initiate contact isolation precautions. Apply permethrin 5% cream (scabicide) to the client’s entire body overnight; rinse off in morning. ⮹ Provide client teaching: ⮹ Treat close contacts, even if asymptomatic, due to delayed symptom onset. Wash clothing and linens in hot water and dry on high heat. ⮹ Apply topical corticosteroids or give oral antihistamines for residual pruritus (can last weeks after treatment). Lice infestation: Teach clients to wash clothing and bedding in hot water and dry on high heat. Avoid sharing brushes or hats. © Bootcamp.com 4 3. Scorpions, Snakes, & Spiders Scorpions, snakes, and spiders inject venom that can damage tissue and cause systemic effects (neurotoxicity, respiratory distress), resulting in coma and death. ⮹ Children require immediate medical care because they have more severe reactions. Common findings ⮹ Localized pain, redness, and swelling Nursing interventions ⮹ Monitor ABCs (airway, breathing, circulation) and provide supportive care for severe reactions (oxygen, IV fluids). ⮹ Clean the wound with antiseptic. ⮹ Apply ice or cool compress to site toî €edema and the spread of venom; do not apply ice to snake bites. Contact poison control for specialized treatment advice. ⮹ Administer analgesics for pain. ⮹ Administer antivenom and tetanus prophylaxis if indicated. Bee & wasp sting interventions: For anaphylactic reactions to bee and wasp stings, administer epinephrine first to vasoconstrict vessels and decrease airway swelling. 4. Bees & Wasps Bee and wasp sting reactions can range from mild to severe; multiple stings or venom allergiesî ‰risk for life threatening anaphylaxis. Findings ⮹ Localized pain, redness, swelling, pruritus ⮹ Anaphylaxis: Airway edema, dyspnea, hypotension Nursing interventions Remove stinger by scraping the skin using a thin, flat object (credit card) to stop venom exposure. ⮹ Do not use tweezers, which can squeeze out more venom. ⮹ Mild reactions ⮹ Clean site with soap and water. ⮹ Apply cool compresses toî €swelling. ⮹ Anaphylactic reactions #1 Priority = administer epinephrine to vasoconstrict vessels andî €airway swelling. ⮹ Monitor airway and vital signs closely. ⮹ Provide oxygen and IV fluids if needed. ⮹ Administer antihistamines and corticosteroids toî €pruritus and swelling. ⮹ Client teaching for bee and wasp venom allergies includes: Always carry an IM epinephrine autoinjector (EpiPen) and wear a medical alert bracelet in case of an anaphylactic reaction. ⮹ Ensure clients and caregivers know how to administer epinephrine. Integumentary ⮹ Avoid wearing bright clothing and perfume, which attract bees and wasps. Bee & wasp sting teaching: Teach clients allergic to bee and wasp venom to always carry an IM epinephrine autoinjector and wear a medical alert bracelet in case of an anaphylactic reaction. © Bootcamp.com 2 5. Poison Ivy (Allergic Contact Dermatitis) Exposure to urushiol oils in poison ivy, oak, and sumac can trigger allergic contact dermatitis. ⮹ Spread through direct contact with the plant or contaminated object. Findings ⮹ Localized, intensely pruritic red rash that develops hours to days after exposure ⮹ Blisters ooze and crust, then resolve (FIGURE 3). FIGURE 3: POISON IVY RASH Integumentary Nursing interventions Wash affected areas immediately with cool water to remove urushiol oils from the skin. ⮹ Avoid scrubbing or using harsh soap, which can spread oils. ⮹ Remove and wash contaminated clothing in hot water. ⮹ Administer topical or oral corticosteroids and diphenhydramine for pruritus. ⮹ Apply compresses of Burow solution (aluminum acetate) and prepare colloidal oatmeal baths to relieve pruritus. Poison ivy: Immediately wash the affected area with cool water to remove urushiol oils from the skin. Avoid scrubbing or using harsh soap, which can spread oils.

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