Pruritus

Definition

Pruritus is an uncomfortable sensation causing the urge to scratch. It is a symptom, not a disease, and can significantly impact quality of life.

Causes

• Dermatologic: eczema, psoriasis, contact dermatitis, urticaria
• Systemic: liver disease (bile salt accumulation), renal failure (uremia), thyroid disease
• Medications (opioids)
• Pregnancy (cholestasis)
• Hematologic: polycythemia vera, lymphoma
• Psychiatric: anxiety, delusional parasitosis

Nursing Interventions

• Cool compresses, colloidal oatmeal baths
• Moisturizers (unscented)
• Short, cool showers
• Loose, cotton clothing
• Keep nails short
• Antihistamines (hydroxyzine, diphenhydramine)
• Topical steroids for inflammation
• Cholestyramine for biliary pruritus
• Treat underlying cause

NCLEX Relevance

Liver failure pruritus: cholestyramine. Short nails for skin protection.