A mother of a school-aged child who was treated for scabies asks the nurse why her child continues to have itching with no sign of mites. Which response by the nurse is the most appropriate?
1. "You will have to switch to something stronger like Lindane (Kwell)."
2. "Itching is common, even after the mites have been killed."
3. "The mites are too small to see, and treatment should be continued."
4. "Permethrin (Acticin) usually works, but your child must need something stronger."
2
Rationale 1:Lindane (Kwell) is prescribed after less toxic drugs are used. The itching is a normal response of the skin after treatment.
Rationale 2: Clients should be aware that penetration of the skin with mites causes itching, which lasts for up to 2–3 weeks, even after the parasites have been killed.
Rationale 3:Treatment has been completed. There is no need to continue with more.
Rationale 4:Permethrin (Acticin) is most commonly used for scabies. The client does not need an additional treatment but reassurance that the itching is common.
Global Rationale: Clients should be aware that penetration of the skin with mites causes itching, which lasts for up to 2–3 weeks, even after the parasites have been killed.
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