A client who has scabies has been admitted to the medical/surgical unit. The nurse knows he should use which of the following precautions when caring for this client?
1. Droplet precautions
2. Airborne precautions
3. Contact precautions
4. Precautions are not necessary with this client
SCABIES
Description
Scabies is a parasitic skin disorder caused by an infestation of Sarcoptes scabiei (itch mite).
Scabies is endemic among schoolchildren and institutionalized populations as a result of close personal contact.
Incubation period
The female mite burrows into the epidermis, lays eggs, and dies in the burrow after 4 to 5 weeks.
The eggs hatch in 3 to 5 days, and larvae mature and complete their life cycle.
Infectious period: During the entire course of the infestation
Assessment Findings: Scabies
Pruritic papular rash
Burrows on the skin (fine grayish red lines that may be difficult to see)
Interventions
Topical application of a scabicide such as permethrin (Elimite) kills the mites.
Lindane, an alternative product that may be prescribed, should not be used in children younger than 2 years because of the risk of neurotoxicity and seizures.
Instruct parents in the application of the scabicide.
When permethrin is used, it is applied to cool dry skin at least 30 minutes after bathing, the cream is massaged thoroughly and gently into all skin surfaces (not just the areas that have the rash) from the head to the soles of the feet (avoid contact with the eyes), left on the skin for 8 to 14 hours, and then removed by bathing; a repeat treatment may be necessary.
Instruct the parents about the importance of frequent handwashing.
Instruct the parents that all clothing, bedding, and pillowcases used by the child need to be changed daily, washed in hot water with detergent, dried in a hot dryer, and ironed before reuse; this process should continue for 1 week.
Instruct parents that nonwashable toys and other items should be sealed in plastic bags for at least 4 days.
Anti-itch topical treatment may be necessary, and antibiotics may be prescribed if a secondary infection develops.