A nurse assesses an older client who is scratching and rubbing white ridges on the skin between the fingers and on the wrists.
Which action would the nurse take?

Choice A rationale

The presence of white flakes that are difficult to brush off the hair is a classic sign of pediculosis capitis, also known as head lice. These flakes are nits, or lice eggs, which are cemented to the hair shaft and are not easily removed. The rash on the back of the neck is often a result of scratching or an allergic reaction to the lice saliva.

Choice B rationale

Impetigo contagiosa is a highly contagious bacterial skin infection characterized by red sores that quickly rupture, ooze for a few days, and then form a honey-colored crust. It typically does not present with white flakes in the hair.

Choice C rationale

Folliculitis is an inflammation of the hair follicles, often caused by a bacterial or fungal infection. It presents as small, red pimples with a hair in the center. It is not associated with white flakes or nits in the hair.

Choice D rationale

Tinea capitis, a fungal infection of the scalp, is characterized by scaly patches of temporary baldness. It may cause inflammation and itching, but it does not produce the characteristic white flakes or nits that adhere to the hair shaft.

Choice A rationale

The presentation of scratching and rubbing white ridges between the fingers and on the wrists is a classic sign of a parasitic mite infestation, specifically scabies. Scabies is caused by Sarcoptes scabiei mites that burrow into the skin. Permethrin is a topical insecticide that is the first-line treatment for scabies because it effectively kills the mites and their eggs.

Choice B rationale

Administering an antihistamine would address the symptom of itching, which is a common manifestation of scabies due to the body's allergic reaction to the mites and their feces. However, it does not treat the underlying cause, which is the parasitic infestation. Antihistamines provide symptomatic relief but will not eradicate the mites, allowing the infestation to persist and potentially spread.

Choice C rationale

Assessing the client's airway is an intervention for a client experiencing an anaphylactic reaction or other respiratory distress. Scabies is a dermatological condition and does not pose a direct threat to a client's airway unless the client has a severe and rare allergic reaction. This action is not relevant to the presenting signs and symptoms of scabies.

Choice D rationale

Applying gloves to minimize friction would not address the underlying pathology of scabies. The purpose of this intervention is to protect the skin from further mechanical damage, but it does not treat the parasitic cause of the condition. While gloves may prevent some scratching, they do not eradicate the mites and are not a primary treatment. .