Medical and Nursing Management of Fungal Skin Disease

V. Medical Management

Tinea capitis
• Griseofulvin for 6 weeks
• Shampoo hair 2 or 3 times with Nizoral or selenium sulfide shampoo

Tinea corporis (body)
• Mild conditions: topical antifungal creams
• Severe conditions; griseofulvin or terbinafine

Tinea cruris (groin area; “jock itch”0
• Mild conditions: topical antifungal creams
• Severe conditions; griseofulvin or terbinafine

Tinea pedis (foot; “athelete’s foot”)
• Soak feet in vinegar and water solution
• Resistant infections: griseofulvin or tervinafine
• Terbinafine (Lamisil) daily for 3 months

Tinea unguium (toenails)
• Itraconazole (Sporanox) in pulses of 1 week a months for 3 months

VI. Nursing Diagnosis

• Impaired skin integrity
• Deficient knowledge
• Disturbed body image
• Acute pain
• Imbalanced nutrition: less than body requirements
• Risk for infection

VII. Nursing Management

Providing general nursing care for fungal skin diseases, which focuses on enhancing skin integrity, providing pain relief, preventing infection, and providing client and family teaching.

Provide nursing care for the client with tinea pedis.
Administer fungal foot sprays
Teach the client to keep his feet as dry as possible, including the area between the toes.
• Small pieces of cotton can be placed between the toes at night to absorb moisture.
• Socks should be made of absorbent white cotton because synthetic material does not absorb perspiration.
• Instruct the client to apply talcum powder or antifungal powder twice daily.
• Instruct the client to alternate shoes so they can dry completely before being worn again.

Provide nursing care for the client with tinea corporis.
• Administer prescribed medications, which may include topical antifungal medication.
• Instruct the client to use a clean towel and washcloth daily.
• Instruct the client to thoroughly dry all skin areas and skin folds that retain moisture.
• Encourage the client to wear clean cotton clothing next to the skin.
• Instruct the client to be careful around pets and pet objects.

Provide nursing care for the client with tinea capitis.
• Administer prescribed medications, including griseofulvin, an antifungal agent. Topical agents do not provide an effective cure because the infection occurs within the hair shaft and below the surface of the scalp.
• Instruct the client and his family to use separate combs and brushes and to avoid exchanging hats and other headgear.
• Encourage the client that all family members and household pets must be examined, because familial infections are relatively common.

Provide nursing care for the client with tinea cruris.
• Administer prescribed medications, which may include topical antifungal medication.
• Instruct the client to avoid excessive heat and humidity as much as possible, including avoiding wearing nylon underwear, tight-fitting clothes, and wet bathing suits.
• Instruct the client to clean, dry and dust the groin area with a topical antifungal agent.

Provide nursing care for the client with tinea unguium.
• Administer prescribed medications, including griseofulvin, an antifungal, orally for up to 1 year.
• Advise the client that response to medication is poor at best; frequently when the treatment is stopped, the infection returns.


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