Pediculosis Capitis Head Lice

Pediculosis Capitis Head Lice Nursing Care Plans Diagnosis and Interventions

Pediculosis Capitis Head Lice NCLEX Review Care Plans

Nursing Study Guide on Pediculosis Capitis (Head Lice)

Pediculosis capitis, commonly known as head lice, is a common contagious infection due to human head lice. It is usually found in young children such as in schools, day care centers, and nurseries, but can also affect adults.

The lice are tiny six-legged parasitic insects that feed on human blood and linger on the human scalp. They are unable to live past one day of not feeding from the human scalp.

Nursing Stat Facts 1

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Nursing Stat Facts 1

Despite being easily transferred from one person to another, head lice do not usually carry viral or bacterial diseases. It is also not necessarily a sign of unclean living conditions or poor personal hygiene.

Signs and Symptoms of Pediculosis Capitis (Head Lice)

  • Itching – the first and most common symptoms of head lice is itching of the scalp, eyebrows, neck, or ears; itching may not experience until 4 to 6 weeks after initial infestation
  • Visible nits (lice eggs) or lice – nits can be found sticking on the hair shafts, but they are so small that they are not easy to spot; lice are small and quick to move away from light
  • Sores – head lice can be extremely itchy, which is likely to result to scratching and sore formation

Causes of Pediculosis Capitis (Head Lice)

Contrary to common belief, head lice are not able to jump or fly; they crawl and get transmitted from an infected person to another through head-to-head contact.

Direct contact usually happens within the family or among the children when playing or attending school. Sometimes, head lice can be transferred indirectly, through using the same comb or brush, in hats, scarves, hair accessories, headphones, and even sharing pillows or towels.

Storing clothing in the same place may also be an avenue for head lice transmission. Domestic pets apparently do not spread human head lice.

Complications of Pediculosis Capitis (Head Lice)

  1. Skin infection. Scratching due to itchiness from head lice infestation may cause multiple skin breaks which put the affected person at risk for skin infection.
  2. Difficulty to focus or bullying. Children may be preoccupied with scratching, taking away their concentration from studying. Some children may be bullied at school due to head lice infestation.

Diagnosis of Pediculosis Capitis (Head Lice)

  • Physical exam – the identification of an adult louse or a live nymph is the gold standard in diagnosing head lice infestation
  • Wood’s light test – the doctor may use a special light which will make the live nits appear bluish; however, nits that are located about ¼ inch or more away from the scalp are likely empty or dead

Prevention of Pediculosis Capitis (Head Lice)

  • Avoid sharing brushes, combs, scarves, and hats and ensure to wash them regularly
  • Have a separate hook for children’s’ garments
  • If a family member has head lice, avoid using the same pillow or lying on the same bed or couch

Treatment for Pediculosis Capitis (Head Lice)

  1. Medications. Medical treatment for pediculosis capitis includes:
  • Over-the-counter (OTC) medications – aim to kill the insects and their eggs. These medications have an active ingredient called pyrethrin, from the flower of chrysanthemum. A synthetic pyrethroid called permethrin is also an approved active ingredient in many head lice OTC creams and lotions. It is important to note that recently laid eggs might not be effectively killed by OTC lice medication. Therefore, a second treatment 7 to 9 days after the initial treatment is recommended by current research studies.
  • Prescription medications – OTC medications may face drug resistance in some regions. In such cases, the doctor may prescribe medications depending on the patient’s age.

2. Wet-combing. Using a fine-toothed nit comb on wet hair can help remove lice and nits. Adding a lubricant such as olive or aloe vera oil on the hair prior to wet-combing can be useful as well.

The hair should be combed from the scalp to the hair ends at least twice per hair section. The process should be done every 3 to 4 days until 2 weeks after the last lice are combed off.

3. Lifestyle changes. The infected person’s items such as clothing, beddings, pillows, and stuffed toys should be washed in at least 130 F or 54 C hot, soapy water. They should also be dried at high heat.

If the items are not to be washed immediately, seal them in a separate plastic bag for a maximum of two weeks. Combs and hair accessories should not be shared. These should be cleaned by soaking in hot, soapy water for 10 minutes.

4. Home remedies. The effectiveness of common home remedies for head lice is still unclear. However, many households attempt to end head lice infestation by using a generous amount of mayonnaise, butter, or olive oil on the hair, covering the hair with a shower cap and leaving it overnight before rinsing off.

Rinsing the hair with white vinegar is also done by some households after shampooing the hair. White vinegar is deemed effective in dissolving the glue that attaches the lice eggs or nits to the hair shafts. After white vinegar, the hair should be washed with warm water. Avoid using any flammable products in attempting to kill the lice.

Nursing Care Plans for Pediculosis Capitis (Head Lice)

Nursing Care Plan 1

Nursing Diagnosis: Impaired Skin Integrity related to itchy scalp secondary to pediculosis capitis (head lice), as evidenced by visible head lice or nits, itchiness of scalp, and erythema or redness of the scalp

Desired Outcome: The patient will re-establish healthy skin integrity by following treatment regimen for head lice.

InterventionRationale
Assess the patient’s scalp.To determine the severity of scalp irritation and any affected areas that require special attention or wound care.
Administer the prescribed medications. Advise the patient and/or carer on how to perform self-application and when to take each of them.Over-the-counter (OTC) medications aim to kill the insects and their eggs (nits). OTC medications may face drug resistance in some regions. In such cases, the doctor may prescribe head lice medications depending on the patient’s age.  
Advise the patient and carer that a second treatment using the OTC head lice medication is strongly recommended.Recently laid eggs might not be effectively killed by OTC lice medication. Therefore, a second treatment 7 to 9 days after the initial treatment is recommended by current research studies.
Encourage wet-combing of hair.Using a fine-toothed nit comb on wet hair can help remove lice and nits. Adding a lubricant such as olive or aloe vera oil on the hair prior to wet-combing can be useful as well.

The hair should be combed from the scalp to the hair ends at least twice per hair section. The process should be done every 3 to 4 days until 2 weeks after the last lice are combed off.
Advise the patient and carer to prevent scratching the affected areas.Head lice can make the scalp itchy, but it is advisable to prevent the patient from scratching the affected areas to prevent worsening of the inflammation and irritation of scalp.
Inform the parent or carer that common household remedies for head lice are not evidence-based or 100% proven effective.The effectiveness of common home remedies for head lice is still unclear. However, many households attempt to end head lice infestation by using a generous amount of mayonnaise, butter, or olive oil on the hair.

Nursing Care Plan 2

Risk for Infection (Transmission)

Desired Outcome: The patient will prevent cross-contamination to other people by following treatment regimen for head lice.

InterventionRationale
Assess any compromise in the integrity of the patient’s scalp, eyebrows, and neck.To determine the severity of scalp inflammation and any affected areas that require special attention or wound care for open sores that may be entry points for infectious pathogens.
Administer medicated head lice lotions or creams as prescribed.To kill head lice and their nits or eggs.
Educate the patient and carer about proper hair and scalp hygiene through washing them with warm water daily and practicing wet-combing.  It is important to maintain the cleanliness of the hair and scalp by daily washing and shampooing with medicated head lice product. Using a fine-toothed nit comb on wet hair can help remove lice and nits.
Trim the patient’s fingernails and ensure frequent hand hygiene. Advise the patient and carer to prevent scratching the affected areas.Long fingernails tend to harbor nits and head lice. Scratching the infected skin areas will allow the skin to break, forming open sores that can make the patient more susceptible to other bacterial infections.
Adhere to recommended lifestyle changes while the person is infected with head lice.The infected person’s items such as clothing, beddings, pillows, and stuffed toys should be washed in at least 130 F or 54 C hot, soapy water.

They should also be dried at high heat. If the items are not to be washed immediately, seal them in a separate plastic bag for a maximum of two weeks.

Combs and hair accessories should not be shared. These should be cleaned by soaking in hot, soapy water for 10 minutes.  
Inform the parent or carer that there is no need for the child to skip school. Instead, they should tell the child to avoid head-to-head contact with other kids.To avoid missed school days while preventing the head lice to be transferred to other children in school.

Other possible nursing diagnoses:

  • Disturbed Body Image
  • Knowledge Deficit

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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