okay lice and scabies these are parasites pathophysiology speaking so lice or pediculosis they suck blood there's excretement where they basically you know their species they suck blood and go to the bathroom on their patient right um and then there's eggs that are actually on the skin and hair and we call those knits i'm going to show you what those look like very scary right they look very tiny but yet very evil so they suck blood there's excretement of feces and then we have eggs on the skin and hair which we call the knits so this is a male version this is our female version what you're seeing here what i've circled are all these little white dots those are the knits those are the late the eggs sorry that have been laid on the hair shaft there okay um over here you're actually seeing the life cycle of these guys so here you have little tiny knits at first right and then within seven to ten days you have a little baby baby nymph is what they call it and then eight to ten days it's a full-blown adult and then within five to six or it lays sorry as an adult five to six knits a day very itchy most my students get very itchy when they when we go through this lecture i can i can very much so see why as to why people would feel that way and then we have scabies scabies also very tiny but also very evil looking right so with scabies these are mites that actually penetrate the skin and they deposit eggs into the skin and so what scabies they really like the folds of skin so you typically see this in folded areas like you know the folds in the wrist between the wedges of the finger and so that's typically where you actually see these so going back to the outline the effect so with lice it can be very red but non-inflammatory they could be papules wheels lots of itching and excoriation um so it's not really as inflammatory as scabies are mainly if maybe we're scratching and we open the skin then we might have inflammation actually occur but typically you just have the knits on the hair shaft and then irritation and itchiness of the skin with the scabies what's happening is the patient's having an actual allergic reaction to the eggs are being inserted under their skin so there is severe itching again you see it in the folds and the inner digits meaning in between the fingers pharmacological treatment so mechanisms of action we will give an ecto-parasitical and that is for um it's basically a particular side and escapiside so we are trying to basically eradicate and kill these guys therapeutic effect it kills we want them to add we want them gone um actually really what it does is it suffocates them and it's kind of funny because i always have this visual of my head have all these little tiny bugs trying to breathe and they can't breathe anymore but that's basically what it's doing is it suffocates them they can no longer breathe they let go and fall off or you'll see though with the um lice that's why they have the combs the combs are to get the knits out of there the knits that are actually attached to the hair shaft so if you had a patient with dandruff remember those flaky white dandruff particles just kind of flake and fly off how you can tell the difference is with the lice with the knits the actual knits are not going to let go those knits you have to remove yourself okay so if you were to take your nail and try and scrape and knit off the hair shaft it's hard to get off it doesn't just slide off the hair shaft it's just stuck there um i don't know if those of you have had kids that have possibly had it before or just you know have taken care of a patient who's had it before that's typically what you're dealing with and what it looks like so again therapeutically we're trying to kill it indications would we want to correctly identify the lice in the scabies and then precautions and contraindications would be if there is a hypersensitivity to the drug or maybe known drug allergy side effects would be skin rash and irritation um what you're seeing underneath of the side effects is actually specific to the particular prototype drug so if you'll see like lindane and malathion those aren't listed prototypes that you have to remember so remembering all the side effects based on those two drugs would kind of be counterproductive so i wouldn't really worry about that um cholinergic toxicity there could be nausea vomiting diarrhea abdominal cramping you can review all of that nursing actions we're going to assess for therapeutic and side effects lifestyle changes correct use of the drugs and follow-up treatment so lifestyle changes we need to basically instruct them as to how to take care of maybe their belongings they've been infected washing everything in hot water cleaning everything very thoroughly bagging stuffed animals and stuff for a certain period of time so hopefully these little bugs eventually just die off on their own because they don't have they don't have a resource to feed off of right they basically feed off of you so they don't have a host to feed off of eventually they're not getting the nutrients they need and they will die um they need to use the medication correctly as well so making sure that they understand the directions of depending on what type of medication that we're giving them and if they need to follow up or possible re-treatment sometimes one treatment is not enough and they will need multiple treatments um or one generally will do it but sometimes it doesn't so it's just important that we're educating about that so make sure the patient and all family members are treated as well that's not listed on the outline but it's something that you really need to remember right if one kid has it they're all probably gonna have it or already do have it so if someone in the family has it we need to make sure the patient and all family members are actually treated okay so examples of drugs you have a permethrin that is the nyx shampoo it's it's a shampoo and topical so it's most commonly used to treat head lice we leave it on for eight to fourteen hours and then we wash it off okay that is the the topical version okay the shampoo we normally put it in follow the shampooing instructions and rinse it out the topical um version of that um is what we use to most commonly treat and we'll leave it on to 18 8 not 18 sorry 8 to 14 hours and then we wash it off and that's for scabies so it's the same treatment nyx is the shampoo version and then the topical ointment cream is the same version of that drug that we would use for someone who has scabies okay so lice is the shampoo scabies is the topical cream version um so the with the cream version they would spread it all over leave it on for eight to fourteen hours and then wash it off normally for scabies again the one application is curative but it isn't always so they need to know when they should follow up all right mrsa or methicillin resistant staphylococcus aureus um typically you find this in the nairs we can also find it in wounds so population at risk population at risk would be patients who are hospitalized and also those that are residing in a long-term care facilities so screening wise typically what we do is a nasal swab so any patient coming from long-term care coming into the acute care setting they will do a nasal swab and send it to the lab to be tested for mrsa and then a pharmacological treatment is mu pyrocine that is um an ointment that we use to treat nasal colonization of mrsa the trade name is bacterban so if you have any questions or need any clarification please don't hesitate to reach out thank you