The parents of a toddler report that the client is having poor sleeping, intense perianal itching, and scratching. The nurse understands that this client is at the highest risk for which condition?
The parents of a toddler report that the client is having poor sleeping, intense perianal itching, and scratching. The nurse understands that this client is at the highest risk for which condition?
A. Anal fissure
[25%]
B. Enterobiasis
[52%]
C. Giardiasis
[20%]
D. Celiac disease
[3%]
Statistics
Subject/Lesson
Subject
Child Health
Lesson
Gastrointestinal
Client Need
Test Plan
Physiological Adaptation
Related Topic
Illness Management
Item Type
Item Type
Analysis
Explanation
Choice B is correct. Enterobiasis is an intestinal infestation by the pinworm Enterobius vermicularis, usually in children, but adult members of their household and caregivers are also at risk. The primary symptom is perianal itching due to female pinworms leaving the intestine through the anus and depositing their eggs on the surrounding skin while the infected individual sleeps. Most cases are in school-aged and young children, with thumb-sucking being a primary risk factor.
Choices A, C, and D are incorrect. An anal fissure is an acute longitudinal tear or a chronic ovoid ulcer in the squamous epithelium of the anal canal. It causes severe pain, sometimes with bleeding, particularly with defecation. Diagnosis is by inspection. Giardiasis is one of the most common causes of waterborne disease worldwide (especially in areas of poor sanitation) caused by the protozoan Giardia duodenalis. Symptoms include watery malodorous diarrhea, abdominal cramps and distention, flatulence, eructation, intermittent nausea, epigastric discomfort, and sometimes low-grade malaise, fatigue, anorexia, and/or failure to thrive. Celiac disease is a hereditary disorder in genetically susceptible people caused by intolerance to gluten, resulting in mucosal inflammation and villous atrophy, which causes malabsorption. Symptoms usually include diarrhea and abdominal discomfort. Diagnosis occurs via small-bowel biopsy and resolves with a strict gluten-free diet.
Learning Objective
Associate perianal itching and poor nocturnal sleeping habits in a toddler with a probable enterobiasis infection.
Additional Info
✓ Pinworm infestation is the most common helminthic infection in the United States.
✓ Enterobiasis infestation is seldom harmful, and reinfestation is common, as ova deposited in the environment can survive three weeks.
✓ Pinworm eggs may be ingested when people touch their mouth after they scratch their perianal area or after they handle contaminated clothes or other objects (e.g., bed linens).
✓ Treatment is available over the counter and may need to be repeated if the hygiene habits are not implemented.
✓ The nurse should recommend that the child adheres to strict hand hygiene, cut the nails short to prevent ova under the nails, and do daily showering.
✓ It is also recommended that linens are washed with warm water.
