Physiological Integrity Q 6
The 5-year-old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms, the nurse should teach the mother to:
A. Examine the perianal area with a flashlight 2 or 3 hours after the child is asleep
B. Scrape the skin with a piece of cardboard and bring it to the clinic
C. Obtain a stool specimen in the afternoon
D. Bring a hair sample to the clinic for evaluation
Correct Answer: A. Examine the perianal area with a flashlight 2 or 3 hours after the child is asleep
Infection with pinworms begins when the eggs are ingested or inhaled. The eggs hatch in the upper intestine and mature in 2–8 weeks. The females then mate and migrate out the anus, where they lay up to 17,000 eggs. This causes intense itching. The mother should be told to use a flashlight to examine the rectal area about 2–3 hours after the child is asleep. Placing clear tape on a tongue blade will allow the eggs to adhere to the tape. The specimen should then be brought in to be evaluated.
Option B: Pinworms do not burrow under the skin, therefore scraping the skin for examination would not reveal pinworms. Enterobius can be diagnosed through a cellophane tape test or pinworm paddle test where an adhesive tape-like material is applied to the perianal area and then examined under a microscope.
Option C: Pinworms are not usually detected in stools. Stool examination is not helpful in the diagnosis of E. vermicularis as they are only occasionally excreted in the stool usually. Sometimes analysis of the stool specimen is recommended to rule out other causes.
Option D: Taking a hair sample is inappropriate because pinworms do not live in hair. The examination might reveal characteristic ova which are 50 by 30 microns in size and have a flattened surface on one side or may reveal the worms. Female worms are around 8 to 13 mm long while male worms are 2 to 5 mm long. The examination is usually done in the early morning for higher diagnostic yield.