Lecturer Subject Topic Venue Participants

: Buque, Jennevy R. : School Nursing ( Intensive Nursing Practicum ) : Enterobiasis : Pasay South High School : 4th Year Nursing Students

TEACHING PLAN

I.

Goal

General Objectives:  To be able to Increase the use of evidence-based, best practice Enterobiasis guidelines for the management of Enterobiasisby all health care providers in order to optimize the quality of health care to individuals with Enterobiasis Specific Objectives  Reduce Enterobiasis deaths.  Reduce hospitalizations for Enterobiasis.  Reduce hospital emergency department visits for Enterobiasis  Reduce activity limitations among persons with Enterobiasis  Reduce the number of school or work days missed by persons with Enterobiasis  Increase the proportion of persons with Enterobiasis who receive formal patient education, including information about community and self-help resources, as an essential part of the management of their condition.

General objectives  Expand and improve the quality of Enterobiasis education, prevention,

management and services.  Decrease the disproportionate burden of Enterobiasis in racial or ethnic minority and low income population.

II.

Content

Enterobiasis  Pinworm infection, an infection caused by a small, white intestinal worm -- the pinworm or, more formally, Enterobius vermicularis. The pinworm is about the length of a staple and lives for the most part within the rectum of humans. While an infected person is asleep, female pinworms leave the intestines through the anus and deposit eggs on the skin around the anus.

Who is at risk for getting pinworms?  Pinworm is the most common worm infection in the United States, and the majority of pinworm infections worldwide occur in temperate climates. Pinworms in children  School-age children have the highest rates of pinworm infection. They are followed bypreschoolers. Institutional settings including day care facilities often harbor cases of pinworm infection. Sometimes, nearly half of the children may be infected. Pinworms in adults  Pinworm infection often occurs in more than one family member. Adults are less likely to have pinworm infection, except for mothers of infected children. However, adult sexual partners can transfer the eggs to each other. What may increase my child's risk of having enterobiasis?  Your child's risk of having the condition increases when he finger sucks or bites his nails. Not washing his hands before eating and not keeping his body clean may also increase his risk. Other family members or friends with pinworms that are not treated may keep re-infecting themselves.

What do pinworms look like (pinworm pictures)?  The pinworms are white, can be seen with the naked eye (no magnification) and are about the length of a staple (about 8-13 mm for female and 2-5mm for male worms). The eggs that are laid by the female worms are not visible as they are about 55 micrometers in diameter and are translucent (see Figure 1).  The male and female worms live for the most part within the rectum of humans but have a life cycle in humans that involves rectal/oral transmission (see Figure 2).  While an infected person is asleep, female pinworms leave the intestines through the anus and deposit eggs on the skin around the anus. This causes itching and irritation of the surrounding area; children especially will scratch the rectal/anal area, get eggs on their fingers or underneath their fingernails and transport the infective eggs to bedding, toys, other humans, or back to themselves. The eggs hatch into larval forms in the small intestines and then progress to the large intestine where they mature, mate, and progress to the rectal/anal area where females deposit about 10 to 15 thousand eggs. What are the signs and symptoms of enterobiasis? The pinworms may only cause itching around your child's anus. The itching is usually the worst at night. You may be able to see adult pinworms around your child's anus. Your child may have no symptoms, or he may have any of the following:
 Decreased appetite, and losing weight without trying.  Irritability and trouble sleeping.  Nausea (upset tummy), or vomiting (throwing up).  Pain in his abdomen (tummy), or diarrhea (loose, watery stools).  Pain when urinated or bed wetting.  Redness or bleeding around your child's anus.  Vaginal infections in females, or infections of the urine passageways.

How is enterobiasis diagnosed? Your child's caregiver will ask you and your child about the symptoms he is feeling. He will ask when they started and how bad they get. He will do a physical exam to look for other problems. Ask your child's caregiver for more information on the following:
 Body fluid and stool exam: Your child's stool, urine, or vaginal fluid may be tested

under a microscope to look for pinworm eggs.

 Colonoscopy: This test is done to look at your child's colon. A tube with a light on

the end will be put into his anus, and then moved forward into his colon.
 Saline swabs: Swabs wet with saline (fluid) are used to wipe around your child's

anus. The swab will be sent to a lab to test for pinworm eggs.
 Skin scrapings: Eggs may also be found on the skin under your child's fingernails.  Tape test: This test can show if there are any pinworms or eggs around your child's

anus. This test is usually done at night or right after your child wakes in the morning. You or your child's caregiver will use a piece of clear adhesive tape. The sticky side of the tape will be patted around your child's anus. Your child's caregiver will then look for eggs using a microscope. This test may be done for three or more days. How is enterobiasis treated? Your child may need any of the following:
 Anti-helminthics: This medicine kills the pinworms inside your child's intestines.

This medicine stops the pinworms from laying eggs. Other family members may also be given this medicine even if they do not have symptoms.
 Medicated creams: This medicine may be given to treat redness, pain, and swelling

at your child's anus. Ask your child's caregiver for information on when and how much to use. What are the risks of having enterobiasis?  Enterobiasis may cause your child's intestines to swell and become painful. Sometimes, your child's intestines may get ulcers (holes) and causes food and liquids to leak inside his abdomen. He may have bleeding from these ulcers. Your child may have pain and swelling of his appendix, or infection in his urine passageways. Your child may not get enough nutrients from the foods he eats. He may become weak and lose weight. Enterobiasis may come back even after your child had been treated. How can I help my child avoid having enterobiasis? You may do any of the following:
 Change your child's clothes, underpants, and bed sheets daily. Be very careful when

cleaning them to decrease the chance of spreading eggs to other things.

 Give your child a bath after he wakes up every morning. Use a clean towel or

washcloth every time. Wash his anus with soap and water.
 Keep your child's nails short and clean, and wash his hands before he holds or eats

food.

 Tell other family members to always wash their hands before and after taking care of

your child.
 Wash your hands after changing your child's diapers or helping him in the bathroom.

When should I call my child's caregiver? Call your child's caregiver if:
 Your child has a decreased appetite.  Your child has a fever.  Your child has diarrhea (loose, watery stools).  Your child is not sleeping.  Your child's anus becomes red and painful.  You have any questions or concerns about your child's condition, medicine, or care.

When should I seek immediate help? Seek care immediately or call 911 if:
 Your child is not gaining weight and feels weak.  Your child has blood in his stools.  Your child has very bad pain in his abdomen. 

How to Prevent  The disease can be prevented by treating all the infected cases and thus eliminating the source of infection. Some ways to keep from catching or spreading the disease include the following recommendations:
 Wash hands thoroughly before handling food and eating.  Keep finger nails short andclean.  Avoiding scratching the anal area.  Take early morningshowers to wash away eggs deposited overnight.  Once the infection has been identified, and treatment is started, change the bed linen,

night clothes, and underwear daily.

 Machine wash linens in hot water and dry with heat to kill any eggs.  Open the blinds or curtains since eggs aresensitive to sunlight.

III. Methodology  Discussion IV. Time Frame Time 8:00- 8:05 8:06- 8:15 8:16- 8:25 8:26- 8:45 8:46- 9:15 9:16- 9:30 9:31- 10:30 10:31- 10:45 10:46- 12:00 12:01- 1:00 1:01- 1:15 1:16- 2:30 2:31- 3:00 3:01- 3:30 3:31- 4:00 4:01-4:30 4:31- 5:00 V. Material  Visual aids VI. Evaluation  Pre-test and Post test VII. Reference Read more: Enterobiasis, Information about Enterobiasis http://www.faqs.org/health/topics/36/Enterobiasis.html#ixzz1g8ALdnTf http://www.faqs.org/health/topics/36/Enterobiasis.html http://www.drugs.com/cg/enterobiasis.html http://www.medterms.com/script/main/art.asp?articlekey=8226 http://www.medicinenet.com/pinworm_infection/article.htm Activity Opening Prayer Checking of Attendance Checking of Paraphernalias Pre-Conference Break Pre-test Lecture Preparation of paraphernalias for H.A Health Assessment Lunch break Preparation of paraphernalias for H.A Health Assessment Coalition of Health Assessment Break Post-test Post conference After care and Dismissal