Pediatric Nursing Demystified

Signs and Symptoms

Gray-tan colored lice visible at the base of the hair

Translucent empty nit cases on the scalp

White specks (nits) close to the scalp

Itching caused by the insects’ movement and saliva on the scalp

Scratch marks on scalp, particularly near ear, nape of neck, and back of head

Inflammatory papules (elevated palpable lesion) due to infected lesions

may be present.

Test Results

Diagnosis is made with discovery of lice, nits, or nit cases on examination

of scalp.

Treatment

Shampoo with pediculicide preparation such as

• Permethrin 1% cream rinse (Nix)


• Pyrethrin with piperonyl butoxide (RID)
  Removal of nit cases
  Malathion 0.5% (children >2 years of age, 8- to 12-hour contact on scalp)
  Daily removal of nits with nit comb or other device to detect and
  remove lice

Nursing alertIf shampoo gets in the eye, flush well with water.

Nursing Interventions

Prevention

Provide client and family teaching regarding the spread of lice.

Instruct parents, and provide education to community and schools,

regarding the importance of not sharing clothing or personal items such

as combs among children.

Maintain the personal items of children in separate containers.

Explain that children who were infected may return to school before nits

are totally absent; remaining nits are often inactive or dead with no risk

for further spread.

Assist with treatment

Clean infested clothing and place in dryer for at least 20 minutes.

Dry clean items that cannot be washed (or seal in a bag for 2 weeks to

allow death of any parasites).

Soak hair care items in lice-killing agent or boiling water.

Systematically inspect the scalp of any child who scratches head, looking

for lice, nits, or signs of infestation.

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(^66) Pediatric Nursing Demystified