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Chapter 12

Coyner, Theresa

Journal of the Dermatology Nurses' Association: March/April 2019 - Volume 11 - Issue 2 - p 95–97
doi: 10.1097/JDN.0000000000000449
DEPARTMENTS: Dermatologic Nursing Essentials Spotlight
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Theresa Coyner, MSN, ANP-BC, DCNP, Randall Dermatology, West Lafayette, IN.

The author declares no conflict of interest.

Correspondence concerning this article should be addressed to Theresa Coyner, MSN, ANP-BC, DCNP, Randall Dermatology, 124 Sagamore Parkway West, West Lafayette, IN 47906. E-mail: tecoyner@gmail.com

Welcome to this column of Dermatologic Nursing Essentials Spotlight where selected excerpts from Dermatologic Nursing Essentials, 3rd Edition, by Heer-Nicol, N., Editor, are shared with the reader. This column focuses on Chapter 12.

Chapter 12, “Bites, Stings, and Infestations,” authored by Coyner and Masterson (2016), identifies the manifestations of biting and stinging insects along with appropriate avoidance behaviors to limit exposure to those insects and common interventions utilized to return the skin to its original condition. Table 12-1, “Potential Vector Diseases from Blood Sucking Insects,” delineates various diseases that may occur from specific insect bites. This is followed by patient education providing guidance on reduction of incidence of bites and stings and eradication of insects from the home environment as well as tips on removal of ticks and ants.

TABLE 12-1

TABLE 12-1

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REFERENCE

Coyner T., Masterson K. N. (2016). Bites, stings, and infestations. InHeer-Nicol N. (Ed.), Dermatologic nursing essentials (3rd ed., pp. 165–180). Philadelphia, PA: Wolters Kluwer.
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Chapter 12

Patient Education

Chiggers, Mosquitoes, and Sandflies

  • The addition of 1 to 2 teaspoons of chlorine bleach to bathwater before possible exposure may reduce natural body odors that attract the female mosquito.

Patient Education

Ticks

  • Meticulous search should be done for ticks on the skin after seeing a tick anywhere.
  • Light-colored clothing increases the visibility of ticks upon clothing.
  • Clothing sprayed with permethrin may be helpful.
  • Tick removal.
  • Do not use petroleum jelly, nail polish, and a burnt match as these methods will cause more harm.
  • Do not use bare hands to remove ticks.
  • Do not compress the body of the tick as it may increase secretion of potentially infectious material.
  • Use tweezers to grasp the tick as close to the skin as possible and pull steadily away from the skin. Avoid a twisting motion.
  • An alternative technique is to tie a thread tightly around the tick’s head as close to the skin as possible and use steady traction to pull away from the skin.
  • Another technique is use of a plastic spoon or a plastic card with a “V” cut out of the center. Slide the “V” under the tick and use steady traction to lift the tick away from the skin.

Patient Education

Bees, Wasps, and Hornets

  • Perfumes and bright-colored and rough-textured clothing are attractive to bees.
  • Beehives and hornets’ nests should not be disturbed. Professional exterminators should be contacted for removal.

Patient Education

Ants

  • One can observe for characteristic mounds of sand or soil.
  • Sandboxes should be checked prior to play sessions for presence of ants.
  • Closed-toe footwear will decrease the incidence of ant bites.
  • Brushing away ants from the skin with a firm article, such as a credit card, will reduce the likelihood of retaining the ant’s head in the skin.

Patient Education

Fleas

  • Treatment of pets and other animals will decrease and possibly eliminate fleas and their eggs.

Patient Education

Bedbugs

  • When bedbugs are seen, thorough vacuuming behind baseboards, in cracks and crevices, and behind peeling wallpaper may be helpful.
  • Bedbugs can be transported in luggage and clothing.
  • Professional exterminators will be needed to eradicate bedbugs.
  • Infested mattresses should be disposed.

Patient Education

Scabies

  • The itching caused by the mite will persist for weeks even after eradication of the mites.
  • Fingernails should be kept short to avoid traumatizing the skin when scratching.
  • All household contacts and sexual contacts should be treated at the same time.
  • Clothing and linen should be changed after overnight or recommended treatment time.
  • Clothing is to be washed with hot water wash and dried in hot dryers.
  • All nonwashable surfaces are to be vacuumed and then seal and dispose of vacuum bag.
  • Fabric articles that cannot be washed or dry cleaned may be encased in plastic for several weeks to avoid reinfestation.
  • Medications: topicals should be thoroughly massaged into body crevices (axillae and groin) as well as under fingernails.
  • Ivermectin is better absorbed with high-fat meal.

Patient Education

Pediculosis

  • All head coverings such as scarves and caps must be dry cleaned or washed in hot water.
  • Combs, brushes, curlers, and hair clips and bows should be washed in hot water.
  • Clothing worn by those with heavy body louse infestation may need the additional precaution of ironing seams as this is the attachment area for oviposits.
  • All bedding, towels, and worn clothing should be washed in hot water and dried in hot dryer.
  • Parents must be instructed about the necessity of thoroughly combing the hair with nit combs. Additionally, it must be reinforced that inspection should be carried out at regular intervals to reduce the possibility of reinfestation.
  • Pubic lice in young or adolescent children may indicate sexual activity.
  • All infested family members must be treated at the same time.
  • Hair conditioners should not be used prior to treatments for lice as the hair conditioner prohibits the treatments from adhering to the hair follicles.
  • Resistance to medications is being reported, but many instances of resistance are due to lack of adherence, incorrect treatment, lack of ovicidal or killing properties of the medication, and reinfestation.
Copyright © 2019 by the Dermatology Nurses' Association.