A 6-year-old child with a history of epilepsy is admitted to the pediatric unit following a breakthrough generalized tonic-clonic seizure at home.
Which interventions should the nurse implement to ensure the child's safety? (Select all that apply.)

Choice A rationale

Allergic reactions to food items typically manifest with systemic symptoms like hives, angioedema, vomiting, or diarrhea, in addition to skin manifestations. While a rash can occur, the localized nature of the dry, scaly patches on the hands, specifically after using a new hand soap, makes a food allergy less likely as the primary cause.

Choice B rationale

Irritant contact dermatitis is a localized inflammatory reaction of the skin caused by direct contact with an irritating substance. New scented hand soaps often contain chemicals and fragrances that can disrupt the skin barrier, leading to erythema, dryness, and scaling, particularly on areas frequently exposed like the hands. The absence of vesicles or oozing supports an irritant rather than an allergic reaction.

Choice C rationale

Fungal infections of the skin, such as tinea manuum, typically present with scaling, redness, and sometimes vesicles or pustules. While a pet can be a source of fungal infections, the recent introduction of a new hand soap makes an irritant reaction a more probable cause than a fungal infection, which usually develops more gradually.

Choice D rationale

Atopic dermatitis (eczema) is a chronic inflammatory skin condition characterized by itchy, red, and scaly patches. While it can affect the hands, it often has a history of exacerbations and remissions and may be associated with other atopic conditions like asthma or allergies. The sudden onset after using a new product points more towards contact dermatitis rather than an eczema flare-up in a child with no significant medical history.

Choice A rationale

For scabies treatment with topical permethrin in children, the medication should be applied from the neck down to the toes, ensuring all skin surfaces are covered because scabies mites can burrow anywhere on the body. The permethrin should be left on for the prescribed duration, typically 8-14 hours or overnight, to allow sufficient contact time to kill the mites and their eggs.

Choice B rationale

Applying permethrin only to affected areas may not be sufficient to eradicate scabies because mites can be present on areas of the skin that do not yet show visible signs of infestation or itching. Complete coverage is necessary to ensure treatment success.

Choice C rationale

Applying permethrin only to the scalp is inadequate for treating scabies, as the mites commonly infest other areas of the body. While scabies can affect the scalp, especially in infants and young children, treatment must extend to all skin surfaces from the neck down.

Choice D rationale

A hot bath should be avoided before applying permethrin. Hot water can irritate the skin and increase absorption of the medication, potentially leading to systemic toxicity or reduced effectiveness. Permethrin is typically applied to cool, dry skin.