A Case Study of a Student with Lice
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
A Case Study of a Student with Lice
The nursing process is a systematic, organized approach to problem solving that nurses use when working with clients. It is neither fixed nor stagnant. It is a flexible process that allows for ongoing changes.
This case study illustrates the use of the nursing process in a school setting.
Sandra Baker is a nurse at an elementary school in a small town. A second-grade teacher brought Carrie Broussard to the clinic and told Sandra that Carrie had been scratching her head all day and she was worried that Carrie might have an infection.
Assessment
Carrie was 7 years old. Her shoulder-length blond hair appeared neat and clean. When questioned by Sandra, Carrie replied that her head had been itching for 2 or 3 days, but she denied any pain or trauma.
Sandra noted that Carrie did not have a fever or swollen lymph nodes, but examination of her scalp revealed multiple excoriated areas. Carrie’s hair was examined with a Wood’s light, and Sandra saw adult lice at the base of the hair follicles on the back of her head, near the nape of the neck.
She also saw multiple nits. Sandra learned that Carrie had two brothers in the school and one sister who was a toddler at home.
On Carrie’s initial visit to the clinic, Sandra assessed the following:
Temperature
Lymph nodes
Scalp for any abnormal findings
Diagnosis
Individual
Head lice
Family and Community (School)
Potential for spread of infestation in both family and school
Educational opportunity to prevent the spread of lice by teachers and family members
Planning
Sandra was familiar with the school district’s policy that covers head lice in schoolchildren. According to the policy, the nurse must do the following:
Individual
Long-Term Goal
Carrie’s return to school after successful treatment
Short-Term Goals
Contact Carrie’s parents to tell them about the lice.
Inform Carrie’s parents that she must be picked up from school.
Recommend treatment based on school protocol.
Provide guidelines for returning to school.
Family and Community
Long-Term Goal
Ensure that the teachers, staff, and family members have the necessary education relative to prevention and treatment of head lice.
Short-Term Goals
Examine the hair of all other children in Carrie’s class for lice, and treat each according to the school protocol.
Check the hair of all siblings who attend the school for lice.
Check the hair of all students in the siblings’ classes if lice are identified.
Intervention
Family
Carrie’s brothers, David and Paul, were brought to the clinic for examination. Both brothers had lice. Sandra contacted Mrs. Broussard, explained the situation to her, and requested that she come to the school to pick up her children.
When Mrs. Broussard arrived at the school, Sandra gave her written information on treatment and prevention of lice and showed her what nits and lice look like.
Mrs. Broussard was also instructed to check other members of the family not attending this school, especially those who share hairbrushes, pillowcases, and towels, because all family members with lice must be treated or the lice would continue to be passed from member to member.
Sandra also explained procedures for cleaning combs, brushes, bedding, and potentially contaminated clothing and toys. Finally, Mrs. Broussard was informed that the children could return to school the day after treatment.
It was obvious to Sandra that Mrs. Broussard was embarrassed. To ease her mind, Sandra carefully explained that head lice are highly contagious, are easily passed from child to child, and are not an indication of poor hygiene. Mrs. Broussard repeated the instructions and left with her three children.
Community
Sandra examined all of the students from each of the Broussard children’s classes for head lice. From the three classes, she identified five more children with head lice and notified their parents.
Those children had siblings in three additional classrooms and she repeated the procedure for each of them. At the end of the day, she had identified a total of 15 children with head lice and contacted all parents.
Sandra investigated whether the teachers and staff desired an information session on the transmission and spread of head lice because so many students had lice. She discovered that it had been 2 years since this was done, and so she arranged a class for the coming week for the teachers and teachers’ aides to learn how to identify and treat head lice.
Evaluation
Individual and Family
Mrs. Broussard brought Carrie, David, and Paul to school the following day, and on examination Sandra found their hair to be free of lice and nits. Mrs. Broussard expressed her appreciation for the nurse’s help and nonjudgmental approach to the problem.
Community
Over the next 2 days, Sandra reexamined all of the children in the affected classrooms and found that the infected children had been successfully treated and that there were no new cases.
New cases were not identified during the remainder of the semester. The teachers and staff gave her positive feedback about the head lice education class and asked for it to be repeated at the beginning of each school year.
Levels of Prevention and School Health
School nursing encompasses all three levels of prevention (i.e., primary, secondary, and tertiary), and all three may be practiced individually or concurrently. Table 30.3 lists examples of school nursing interventions for each of the three levels of prevention.
Visit a comprehensive school-based clinic in your area. Discuss how the care given in this type of clinic differs from the care that a school nurse can provide. Review the protocols of both settings and see how they differ.
What is the cultural makeup of your local area? How should this knowledge influence the school nurses’ practice?
RUBRIC
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