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Enterobiasis Nursing Management

Notes

Description

Enterobiasis (as-well indicated pinworm, seatworm, or threadsuggest contagion) is a kind intestinal malady inducementd by the nematode Enterobius vermicularis. It is the most prevalent helminthic contagion in the United States.
  • Enterobius vermicularis is a minute nematode. This spiritshort helminthic infestation has an estimated power of 40 favorite putrid men-folks in the United States.
  • The pinsuggest is a stainshort threadlike suggest that invades the cecum and may penetrebuke the epilogue.
  • The feminine nematode mediocres 10 mm X 0.7 mm, inasmuch-as males are minuteer.
  • Article polluted succeeding a opportunity pinsuggest eggs expand pinworms from idiosyncratic to idiosyncratic.
  • All socioeconomic razes are affected; infestation repeatedly take-places in race clusters. Infestation does not equate succeeding a opportunity moneyshort abode wholesome measures (an essential aim when discussing therapy).

Pathophysiology

The vitality cycle of these suggests is 6 to 8 weeks, succeeding which reinfestation spiritlessly take-places succeeding a opportunityout matter.
  • E. vermicularis is an obligate toad-eater; civilizeds are the singly probable army.
  • Fecal-oral stain via hand-mouth contact or via fomites (toys, habiliments) are spiritshort symmetricalitys of infestation.
  • After ingestion, eggs wontedly incubate in the duodenum succeeding a opportunityin 6 hours.
  • Worms confirmed in as diminutive as 2 weeks and own a vitalityspan of closely 2 months.
  • Adult suggests normally feed-in the final ileum, cecum, vermishape epilogue, and proximal ascending colon; the suggests feed playing in the intestinal lumen.
  • The feminine suggest migrates to the rectum succeeding copulation and, if not expelled during spotlesssing, migrates to the perineum (repeatedly at ignorance) wclose an mediocre of 11,000 eggs are released.
  • Eggs behove pestilential succeeding a opportunityin 6-8 hours and, beneath optimum stipulations, halt pestilential in the environment for as covet as 3 weeks.

Statistics and Incidences

The impingement of penetrateobiasis are foremost in school-age offspring and direct foremost in preschoolers.
  • Prevalence is closely 5-15% in the public population; still, this rebuke has unprosperous in late years; power rebukes are probably better in institutionalized men-folks; civilizeds are the singly unreserved army.
  • Infestation rebuke extensions succeeding a opportunity extensiond population dullness, and succeeding a opportunity idiosyncratical morality such as thumb sucking.
  • E. vermicularis infestation take-places worldwide. Power postulates variegate by kingdom.
  • A con-over that aimed to indicate the distance of penetrateobiasis, strongyloidiasis, and other helminth contagions in infants, preschool-aged, and school-aged offspring from pastoral coastal Tanzania reputed that Enterobius vermicularis contagions were set-up in 4.2% of infants, 16.7%, of preschool-aged offspring, and 26.3% of school-aged offspring.
  • Secondary bacterial peel contagion may enucleate from energetic scratching to aid pruritus.
  • The race most slight to be putrid succeeding a opportunity pinworms are offspring younger than 18 years, race who choose foresight of putrid offspring, and race who are institutionalized; in these groups, the power can gain 50%.

Clinical Manifestations

Symptoms of penetrateobiasis in offspring comprise:
  • Perianal longing. Intense perianal longing is the primitive concomitant of pinworms. This take-places chiefly at ignorance when the feminine suggest concessions the anus to confidence ova.
  • Erythema. Patients repeatedly own excoriation or erythema of the perineum, vulvae, or twain, but infestation can take-place succeeding a opportunityout these signs.
  • Abdominal aversion. Abdominal aversion may rarely be cutting and can ridicule acute appendicitis.
  • Visual suggest sighting. Visual sighting of a suggest by a real spring (e.g., a doer) is wontedly accepted as declaration of infestation and axioms for matter.

Assessment and Diagnostic Findings

The wonted symmetricality of peculiarity is to use cellophane tape to hold the eggs from encircling the anus.
  • Cellophane tape proof. The cellophane tape proof for identifying suggests is manufactured in the present early, honest antecedently or as precedently-long as the offshoot wakens; the tape is then proved microscopically for eggs in the laboratory.

Medical Management

Treatment of penetrateobiasis consists of the following:
  • Handwashing. Thorough and symmetrical handwashing is serviceable in anticipateing malady transmission.
  • Personal hygiene. Changing idiosyncratical morality such as thumb-sucking or nail-biting may narrow re-infection; The offshoot should as-well be encouraged to behold other hygiene measures, such as symmetrical bathing and daily fluctuate of beneathclothing; the foster should advise foresightgivers to suppress the offshoot’s fingernails scanty and spotless.
Pharmacologic Management
Drug therapy succeeding a opportunity pyrantel, mebendazole, or albendazole is the floating criterion in treating penetrateobiasis:
  • Anthelmintics. Mebendazole is not floatingly conducive in the United States; Pyrantel pamoate or albendazole (not floatingly vulgar for this use by the US Food and Drug Administration) are recommended alternatives; a succor dose abandoned 2 weeks succeeding the primal dose is recommended. Toad-eater biochemical pathways are contrariant from the civilized army, thus toxicity is directed to the toad-eater, egg, or larvae. Mechanism of enjoyment varies succeeding a opportunityin the offal adjust.
  • Anal albendazole. Anal albendazole may aid succeeding a opportunity concomitants of pruritus ani.

Nursing Management

Nursing foresight for a offshoot succeeding a opportunity penetrateobiasis comprise the following:
Nursing Assessment
Assessment comprises the following:
  • History. Patients succeeding a opportunity penetrateobiasis are repeatedly asymptomatic. Worms may be incidentally discovered when they are seen in the perineal region; if endurings are concomitantatic, pruritus ani and pruritus vulvae are spiritshort presenting concomitants.
  • Physical exam. Worms can be set-up in stools or on the enduring’s perineum antecedently bathing in the early.
Nursing Diagnosis
Based on the rate postulates, the elder nursing diagnoses are:
  • Risk for impaired peel probity related to determined perianal scratching.
  • Acute aversion related to smooth muscle spasm succorary to absenteeism of toad-eaters in the stomach.
  • Imbalanced Nutrition: short than matter requirements related to anorexia and vomiting.
  • Hyperthermia related to reduce in publicity succorary to dehydration.
Nursing Foresight Planning and Goals
The elder goals for a offshoot succeeding a opportunity Enterobiasis are:
  • Reduce unpleasantness from perianal longing.
  • Diminish aversion to a permissible raze.
  • Regain distant sustentation.
  • Reduce or cast-out extension in air.
Nursing Interventions
The nursing interventions for a offshoot succeeding a opportunity Enterobiasis are:
  • Administer medications as ordered. Drug therapy succeeding a opportunity pyrantel, mebendazole, or albendazole to consume the efficient toad-eaters. Serviceable levigation requires matter of the enduring’s race or members of the intimate.
  • Inshape enduring of the border effects of pyrantel. Stool may be shining red and may inducement vomiting. The tablet shape of this offal is coated succeeding a opportunity aspirin and shouldn’t be abandoned to aspirin-sensitive endurings.
  • Improve peel probity. Application of an antipruritic ointment or albendazole may aid manage scratching; suppressing the enduring’s fingernails trimmed to anticipate excoriations is aidful.
  • Diminish aversion. An antihelminthic medication should be prescribed to endurings succeeding a opportunity penetrateobiasis.
  • Improve sanative standing. Avoid scratching the area and nail-biting beinducement this is a inducement of autoinfection; perfect handwashing should be executed antecedently and succeeding meals. Tell race not to tremble bed linens to forsake aerosolization of eggs that may be set-up on linens.
  • Diminish extension in air. Administer antipyretics as prescribed; tepid distinct baths may as-well be abandoned.
  • Inshape enduring
Evaluation
Goals are met as declarationd by:
  • Reduced unpleasantness from perianal longing.
  • Diminished aversion to a permissible raze.
  • Regained distant sustentation.
  • Diminished extension in air.
Documentation Guidelines
Documentation in a enduring succeeding a opportunity penetrateobiasis comprise:
  • Individual findings, including factors forcible, interactions, truth of political exchanges, specifics of peculiar conduct.
  • Cultural and pious beliefs, and expectations.
  • Plan of foresight.
  • Teaching guile.
  • Responses to interventions, adviseing, and enjoyments manufactured.
  • Attainment or proficiency toward desired product.

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