A child suspected to have pinworm, to confirm the nurse should tell the mother to?

AIIMS Rishikesh & Jodhpur NO - 2017

Child Health Nursing (Pediatrics)

Medium

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

The correct instruction is to observe the child's anal area in the early morning, immediately after waking.
This method is based on the lifecycle of the pinworm (Enterobius vermicularis), where the gravid (egg-filled) female worm migrates to the perianal skin at night to lay thousands of eggs.
The worms, which look like small white threads, may be visible to the naked eye before the child bathes or has a bowel movement.
This is the most common and practical initial step a parent can take to confirm the infection visually.

Option A: Pinworm eggs are deposited on the perianal skin, not typically passed within the feces. Therefore, examining a stool sample with the naked eye is highly unlikely to reveal evidence of pinworms.
Option B: A stool culture is a laboratory test used to grow and identify bacteria or fungi causing an infection in the digestive tract. It is not used to diagnose parasitic worm infections like pinworms.
Option D: This option is incorrect because the methods involving stool samples (options A and B) are not effective or appropriate for diagnosing a pinworm infection.

Clinical Relevance

Nursing practice connection: Use the key finding related to Diagnostic procedure for pinworm (Enterobiasis) infection to guide bedside assessment, documentation, and the next nursing action.
Patient education is a key nursing role. The nurse must provide clear, simple instructions to parents on how to check for pinworms and how to perform the tape test correctly for a definitive diagnosis.
The definitive diagnostic method is the 'tape test.' The nurse should instruct the parent to press clear adhesive tape to the child's perianal skin in the morning before bathing, then place the tape on a glass slide for microscopic examination for eggs.
To increase diagnostic accuracy, the tape test should be performed for at least three consecutive mornings.

How to Approach the Question

First, identify the specific condition mentioned in the question: pinworm infection.
Recall the basic pathophysiology and lifecycle of the pinworm (Enterobius vermicularis). The key feature is the nocturnal migration of the female worm to the perianal area to lay eggs.
Evaluate each option based on this lifecycle. The most effective diagnostic method will target the location and timing of egg deposition.
Eliminate options that are inconsistent with the lifecycle. Stool samples are ineffective because eggs are laid on the skin, not passed in the stool.
Select the option that aligns directly with the worm's behavior: observing the perianal area in the early morning when the worms or their eggs are most likely to be present.

Concept Tested & Keywords

Concept Tested: Diagnostic procedure for pinworm (Enterobiasis) infection.
Stem keywords: child, pinworm, confirm, nurse, mother
Lead-in keywords: to confirm
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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