Question

The nurse is caring for a client with a diagnosis of hepatitis who is experiencing pruritis. Which would be the most appropriate nursing intervention? A. Suggest that the client take warm showers B.I.D. B. Add baby oil to the client's bath water C. Apply powder to the client's skin D. Suggest a hot-water rinse after bathing

Short answer

Answer: Adding baby oil to the client's bath water.

Step-by-step solution

Evaluate Option A

Evaluate whether suggesting the client take warm showers B.I.D. (twice daily) is an appropriate intervention. Warm showers can relieve itching, but they shouldn't be too hot, as this may make the itching worse. In addition, there's no mention of the frequency of the showers, which might be considered excessive if it's twice daily.

Evaluate Option B

Evaluate if adding baby oil to the client's bath water is an appropriate intervention. Baby oil can be very helpful for moisturizing the skin, reducing skin dryness and itching. Adding it to the bathwater might help soothe the skin, making it a possibly good choice.

Evaluate Option C

Evaluate whether applying powder to the client's skin is an appropriate intervention. Powders are not usually recommended for itching because they can potentially dry out the skin, making the itching worse.

Evaluate Option D

Evaluate if suggesting a hot-water rinse after bathing is an appropriate intervention. Hot water can potentially cause more harm than relief, as it might strip away the skin's natural oils, leading to increased dryness and itching.

Determine the most appropriate intervention

Based on our evaluation, we can rule out options A, C, and D as they may not provide the necessary relief from itching or may even exacerbate the itching. The most appropriate nursing intervention would be Option B: adding baby oil to the client's bath water, as it helps soothe and moisturize the skin, potentially reducing the itching sensation.

Key concepts

Hepatitis Patient Care

Caring for patients with hepatitis entails addressing a multitude of symptoms that can negatively impact their quality of life, pruritus being one of them. It requires a holistic approach that considers the various systems affected by the disease, particularly the liver's functionality.

For hepatitis patients, the primary care goals include managing symptoms, preventing complications, and minimizing liver damage. It is essential to provide gentle skin care routines to avoid further irritation, advise on dietary changes to support liver health, and ensure the patient remains hydrated. In terms of pruritus specifically, interventions should aim at soothing the skin without causing additional harm. For instance, recommending tepid showers rather than hot ones, and using emollient-rich bath additives can help maintain skin moisture.

Itch Relief Strategies

Pruritus or itching can be an incredibly distressing symptom for patients, particularly those with compromised liver function as seen in hepatitis. Itch relief strategies encompass a variety of approaches.

Moisturizing

Regular use of moisturizers is vital for maintaining skin hydration and barrier function. Unscented lotions or creams are preferred to reduce the risk of further skin irritation.

Cooling Techniques

Cold packs or cool compresses applied to the itchy areas can provide immediate, albeit temporary, relief.

Topical Treatments

Over-the-counter anti-itch creams containing ingredients like menthol, camphor, or pramoxine can also help.

Medications

In some cases, antihistamines or corticosteroids may be prescribed by a healthcare provider. It is crucial to discuss any treatments with a healthcare provider to ensure they are safe for use in patients with liver conditions.

Therapeutic Baths in Nursing

Therapeutic baths are an important non-pharmacological nursing intervention that can provide comfort and symptom relief for various conditions, and they are particularly beneficial in managing pruritus.

When administering therapeutic baths, the temperature of the water should be lukewarm to avoid exacerbating itching or drying out the skin. To enhance the therapeutic effect and moisturizing properties of the bath, adding a substance like baby oil, as highlighted in the textbook solution, can be greatly helpful.

Bath Additives

Options like oatmeal colloids, Epsom salts, or baking soda have also been known to relieve itching and soothe the skin.

Bathing Technique

Patients should be advised to pat dry gently instead of rubbing the skin vigorously after the bath, and to immediately apply moisturizer to lock in moisture.

Timing

While therapeutic baths are beneficial, it's crucial to keep them short to prevent skin pruning, which can lead to an increased risk of infection or irritation.