Assessment
Pruritus is a symptom, not a diagnosis or disease. Generalized pruritus is a
“cardinal symptom of medical significance”[1] and should be taken seriously.
Assessment of pruritus must incorporate an accurate and thorough history and
physical examination. The history includes the following data:[2,3]
- Location, onset, duration, and intensity of itching.
- Previous history of pruritus.
- Previous history of malignant disease.
- Current malignant disease and treatment.
- Nonmalignant systemic diseases.
- Use of analgesics.
- Use of antibiotics.
- Use of other prescription and nonprescription drugs.
- Presence of infection.
- Nutritional and fluid level status.
- Current skin care practices.
- Existence of other pruritic risk factors.
- Review of relevant laboratory values (complete blood cell chemistry).
- Factors that relieve and aggravate itching.
- Patient's emotional state.
Physical examination will provide data from assessment of the following:
- All skin surfaces for signs of infection.
- All skin surfaces for signs of drug reaction.
- Environmental factors (temperature, humidity).
- Physical factors (tight, constrictive clothing).
- Evidence of scratching (erythema, dryness, excoriation).
- Skin turgor, texture, color, temperature, and lesions.
References
-
Bernhard JD: Clinical aspects of pruritus. In: Fitzpatrick TB, Eisen AZ, Wolff K, et al., eds.: Dermatology in General Medicine. 3rd ed. New York, NY: McGraw-Hill, 1987, Chapter 7, pp 78-90.
-
Lydon J, Purl S, Goodman M: Integumentary and mucous membrane alterations. In: Groenwald SL, Frogge MH, Goodman M, et al., eds.: Cancer Nursing: Principles and Practice. 2nd ed. Boston, Mass: Jones and Bartlett, 1990, pp 594-635.
-
Pace KB, Bord MA, McCray N, et al.: Pruritus. In: McNally JC, Stair JC, Somerville ET, eds.: Guidelines for Cancer Nursing Practice. Orlando, Fla: Grune and Stratton, Inc., 1985, pp 85-88.
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