Altered comfort: pruritus
related to stimulation of itch receptors in the skin by bile acid metabolites that accumulate in the blood as a result of bile flow obstruction.
|The client will experience relief of pruritus as evidenced by:|
- verbalization of same
- no scratching or rubbing of skin.
|Nursing Actions and Selected Purposes/Rationales|
- Assess for the following:
- reports of itchiness
- persistent scratching or rubbing of skin.
- Instruct client in and/or implement measures to relieve pruritus:
- apply cool, moist compresses to pruritic areas
- apply emollient creams or ointments frequently to prevent dryness
- add emollients, cornstarch, or baking soda to bath water
- use tepid water and mild soaps for bathing
- pat skin dry after bathing, making sure to dry thoroughly
- maintain a cool environment
- encourage participation in diversional activity
- utilize relaxation techniques
- utilize cutaneous stimulation techniques (e.g. massage, pressure, vibration, stroking with soft brush) at sites of itching or acupressure points
- encourage client to wear loose cotton garments and avoid clothes or blankets made from wool
- administer the following medications if ordered:
- antihistamines (e.g. diphenhydramine, hydroxyzine [Atarax])
- bile acid sequestering agents (e.g. cholestyramine).
- Consult appropriate health care provider (e.g. clinical nurse specialist, physician) if above measures fail to alleviate pruritus or if the skin becomes excoriated.