Chapter 30: Pediculosis Capitis (Lice) In Children

Question 1

Pediculosis Capitis

Answer 1

head lice; infestation

• passed among friends and family
• the lice pierce the skin and suck blood
• the bites can cause severe itching and can predispose to secondary infection

Question 2

Signs and Symptoms

Answer 2

> Live lice
-tend to live near the nape of the neck and behind the ears
Louse eggs (nits)
-can be found anywhere along the shaft of the hair; the older the nits are, the more distal
-pearlescent teardrop in shape, laid at the base of the hair shaft
-fluoresce blue under a Wood’s lamp

Question 3

Safety: Nits on Eyelashes

Answer 3

sign of sexual abuse

Question 4

Diagnosis

Answer 4

clinical presentation and identification of the louse and/or it eggs is important
-persistent itching of the head is a classic sign

Question 5

Prevention

Answer 5

• avoid use of another’s comb, barrettes, hats, and headbands
• children with active lice need treatment as well as their environment; all associated persons affected by lice are treated

Question 6

Nursing Care

Answer 6

• educates family about OTC lice treatments
• explain that anyone can get lice if in close proximity to others to happen to have it
• lice-common in school-aged children, and no need for embarrassment

Question 7

Medical Care

Answer 7

-OTC lice treatments
>pediculicide treatments:
-pyrethroids, such as permethrin (Nix)[not for under 2 months of age] and malathion (Ovide) [over age 2]
-anti-parasitic like benzyl alcohol (Stromectol) [not recommended for infants under 6 months]
-Ivermectin; orally
-pharmacological shampoo after age 2

Question 8

“What to Say”: When parents inquire about lice

Answer 8

• asks family members if there is a recent history of another family member with infestation
• ask the school nurse or day-care provider if there is a lice infestation in that setting
• communicates that a “nit check” of each individual will help the family members determine who needs treatment
• reminds family that b/c they may acquire lice from the affected child, they can take the same treatment actions

Question 9

Education/ Discharge

Answer 9

• wash hair according to products instructions
• if unable to tolerate shampoo, use of asphyxiants like petrolatum and food oils (e.g. olive oil) can be used; once shampoo is rinsed, remove nits by backcombing with a fine-tooth comb while hair is still wet)
• implement house cleaning
• wash clothing and bedding
• wipe off hats, helmets, and toys
• if not washable, must be bagged in a sealed plastic bag and away from family members’ rooms for 14 days
• launder bed linens in hot water
• pillows are washed if possible or thrown away
• anti-lice sprays can be sued for furniture and other environmental objects that are not disposable
• vacuum
• hair-care items can be boiled or soaked in anti-lice shampoo and never shared
• remove nits from eyelashes by applying petrolatum jelly to eyelashes twice a day for 8 days
• check schools anti-lice policy; must remain home until lice free
• rechecked for infestation in 7 to 10 days

Question 10

How to Prevent the Spread of Pediculosis

Answer 10

• assess for lice using good lighting and examining the child’s head to identify both live (very small and brown or black) and nits
• separate sections of the hair, paying attention to the area behind the ears and the nape of the neck
• teach family members that this dandruff-like appearance cannot be easily removed b combing because of the sticky adherence of the nit