Authors

  1. Rushing, Jill RN, MSN

Article Content

LICE ARE PARASITIC INSECTS that can be found on a patient's head, body, or public area. Lice are commonly transmitted through direct person-to-person contact or indirectly from shared items such as combs, hats, or linens.

 

DO

 

* Provide privacy. Implement contact precautions and maintain them for 24 hours after therapy starts.

 

* Remove the patient's clothing and place it in a sealed plastic bag.

 

* Search for head lice with a fine-tooth comb, a magnifying glass, and a strong light. Examine the comb for living lice (see figure below). Assess the hair shaft for nits (lice eggs), which are yellow or white ovals that can't be removed easily. Pick them up with clear tape.

 

* Examine her eyebrows and eyelashes. Check the skin behind her ears and near her hairline along the posterior neck and occiput.

 

* Assess her for itching and scratching, especially in hair-covered areas, and look for uninfected bite marks (erythematous papules, 2 to 4 mm in diameter) or hives. Assess scratch marks for signs and symptoms of infection (redness, drainage, swelling, or pain).

 

* Teach the patient or her caregiver about chemical pediculicides, and tell her to follow the directions exactly. Treatment may need to be repeated to kill newly hatched lice.

 

* Teach her or her caregiver to treat eyelash infestation with an ophthalmic-grade petroleum ointment that's available only by prescription.

 

* Tell her or her caregiver not to use gasoline, kerosene, turpentine, paint thinner, or industrial or garden pesticides, which are poisonous or dangerous, or oils, whose benefit hasn't been proven.

 

* Anyone in close contact with the patient should be treated simultaneously. If she's in day care or school, urge her parents to inform the facility. Refer to the Centers for Disease Control and Prevention Web site for more patient-teaching information.

 

* Advise her to use over-the-counter medications such as antihistamines to relieve itching, if recommended by the health care provider.

 

DON'T

 

* Don't use regular petroleum jelly for lice nits on eyelashes because it's likely to irritate the eyes.

 

* Don't use antilice agents on the face, eyes, or mucous membranes.

 

RESOURCES

 

Centers for Disease Control and Prevention. Lice infestation: Pediculosis and phthiriasis. Fact sheets on head lice infestation (pediculosis), body lice infestation (pediculosis), and treating head lice infestation. http://www.cdc.gov/ncidod/dpd/parasites/lice/default.htm. Accessed April 9, 2008.

 

Rubeiz N, Kibbi A-G. Pediculosis. http://www.emedicine.com/emerg/topic409.htm. Accessed April 9, 2008.

 

Siegel JD, et al., and the Healthcare Infection Control Practices Advisory Committee. 2007 Guideline for Isolation Precautions: Preventing transmission of infectious agents in healthcare settings. http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf. Accessed April 9, 2008.