A school nurse is completing routine health evaluations for school-age children. Which of the following manifestation should alert the nurse to the possibility of pediculosis capitis?

A. "Take a hot shower daily to relieve itching."

This instruction is not recommended because hot water can exacerbate itching and worsen the condition. Hot showers can strip the skin of its natural oils, leading to further dryness and irritation, which may aggravate the itching associated with scabies.

B. "Wear loose fitting clothing while you are experiencing itching."

This instruction is appropriate because loose-fitting clothing can help minimize friction and irritation on the skin affected by scabies. Tight clothing can exacerbate itching and discomfort, so wearing loose clothing can provide relief and allow the skin to breathe.

C. "Add fabric softener to linens when they are washed."

This instruction is not recommended because fabric softeners may contain chemicals or fragrances that can irritate the skin, especially for someone with pruritus or scabies. It's best to use gentle, fragrance-free laundry detergent to wash linens and clothing to minimize potential irritation.

D. "Use a soft bristle brush to gently rub the affected areas."

This instruction is not recommended because using a brush, even if it has soft bristles, can further irritate the skin and potentially spread the scabies mites to other areas of the body. It's best to avoid any abrasive or vigorous rubbing of the affected areas and instead focus on gentle cleansing and moisturizing techniques.

A. "There are a few causes of this condition and they tell me my child has crossed eyes because of a muscle imbalance.": This statement demonstrates the mother's comprehension of the cause of strabismus, which can indeed result from a muscle imbalance affecting the alignment of the eyes. Understanding the cause is essential for the mother to grasp the rationale behind treatment interventions.

B. "I will have my child wear an eye patch over the good eye to help strengthen the weak eye.": Patching the stronger eye is a common treatment approach for strabismus to encourage the weaker eye to become stronger and improve alignment. The mother's statement indicates her awareness of this treatment modality.

C. "My child will outgrow this by the time he is 2 years old and be able to see just fine.": While some cases of strabismus may improve as a child grows, not all cases resolve spontaneously. This statement suggests the mother's belief in the possibility of spontaneous resolution, which may be accurate in some instances but not guaranteed for all cases of strabismus.

D. "If this eye patch does not work I know we will have to do surgery to correct my child's crossed eyes.": Surgery is indeed an option for correcting strabismus, especially if conservative measures like patching do not yield satisfactory results. The mother's understanding of this potential treatment escalation reflects her grasp of the condition's management plan.