Question

A child has been diagnosed with scabies. In addition to washing the child with the prescribed medication, the nurse would instruct the mother to: A. wash all bed linens in hot soapy water. B. wash all fruits and vegetables before use. C. have the family's dog checked for evidence of infestation. D. discard all of the child's clothing and replace with new clothing.

Short answer

The nurse would instruct the mother to wash all bed linens in hot soapy water, as this effectively kills the mites that cause scabies.

Step-by-step solution

Understanding Scabies and Its Transmission

Recognize that scabies is caused by an infestation of tiny mites that can burrow under the skin. It's contagious and can spread through close physical contact or through bedding, clothing, and furniture that has been used by someone with scabies.

Identifying the Method of Decontamination

The mites can survive for about 48 to 72 hours without human contact, so it's important to wash any items that may have come in contact with the infested person. Hot soapy water is effective in killing the mites when washing bed linens, clothes, and other fabrics.

Instructions on Preventing Reinfestation

Instructing the mother to wash all bed linens in hot soapy water will help to kill any mites and eggs present, preventing reinfestation and spread of the condition.

Review of Other Options

Washing fruits and vegetables (Choice B) is not related to preventing or treating scabies. Having the family's dog checked for evidence of infestation (Choice C) could be considered if there is concern for animal scabies, but it's not a common recommendation for human scabies. Discarding all of the child's clothing (Choice D) is unnecessary and impractical; washing the clothing in hot soapy water is sufficient.

Key concepts

NCLEX-RN Exam Preparation

Preparing for the NCLEX-RN exam involves understanding a wide range of nursing concepts, including the management of communicable diseases like scabies. For nursing students, mastering this content is crucial for both exam success and professional practice. Start by familiarizing yourself with the life cycle and transmission modes of scabies mites, the signs and symptoms of the infestation, and the treatment protocols. Ensure that you also understand the public health implications and the measures for preventing the spread of the condition.

Use study guides and practice questions to evaluate your knowledge, focusing on scabies as an example of an infectious condition managed by nurses. Pay attention to the safety and infection control section of the NCLEX-RN, as questions may relate to the appropriate interventions to prevent and control infestation. Additionally, participating in study groups and simulation labs can help reinforce the practical skills needed for effective nursing care and patient education on scabies.

Nursing Care for Scabies

Nursing care for scabies starts with an accurate assessment, prompt diagnosis, and the implementation of an effective treatment plan. The nurse plays a pivotal role in educating patients and their families about the condition, how it spreads, and the importance of adhering to treatment guidelines.

As part of the care, nurses should advise on thorough and regular cleaning of personal items, including bed linens and clothes. When educating a patient's family, emphasize the need to wash potentially contaminated items in hot soapy water to eradicate mites. This can be facilitated by providing written instructions and demonstrating techniques if necessary. Additionally, nurses should educate families on the importance of treatment compliance and follow-up appointments to ensure the infestation is fully resolved. Monitoring for adverse reactions to medications and counseling on how to mitigate the itching and discomfort associated with scabies are also key components of nursing care.

Scabies Decontamination Methods

Effective scabies decontamination is crucial for preventing reinfestation and controlling the spread within households and communities. Where nursing intersects with decontamination, there are specific methods to recommend.

Bedding and Clothing

Advise patients or their caregivers to wash bedding, clothing, and other fabric items in hot water, at a temperature of at least 122°F (50°C), and to dry these items in a hot dryer for at least 30 minutes. This is the most reliable way to kill mites and their eggs.

Non-Washable Items

For items that cannot be washed, such as shoes or plush toys, sealing them in a plastic bag for at least 72 hours can help ensure that mites die off, as they cannot survive long without a human host.

Home Cleaning

Regular vacuuming of floors, furniture, and mattress surfaces, followed by proper disposal of the vacuum bag, can remove mites and eggs. While fumigation isn't typically required, high-contact surfaces should be wiped down with disinfectant to minimize the risk of transmission.

By adhering to these methods, nurses can provide comprehensive instructions that are integral to the prevention and management of scabies outbreaks.