Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort?
A. Give tepid baths.
B. Avoid lotions and creams.
C. Use hot water to increase vasodilation.
D. Use cold water to decrease the itching.
Correct Answer: A. Give tepid baths.
For pruritus, care should include tepid sponge baths and use of emollient creams and lotions. Bathe or shower using lukewarm water and mild soap or nonsoap cleansers. Long bathing or showering in hot water causes drying of the skin and can aggravate itching through vasodilation.
Option B: Lubrication with fragrance-free creams or ointments serves as a barrier to prevent further drying of the skin through evaporation. Moisturizing is the cornerstone of treatment. Over-the-counter moisturizing lotions include Eucerin, Lubriderm, and Nivea. Lotions are lighter and less emollient than creams.
Option C: Encourage the patient to adopt skincare routines to decrease skin irritation. After bathing, allow the skin to air dry or gently pat the skin dry. Avoid rubbing or brisk drying. Rubbing the skin with a towel can irritate the skin and exacerbate the itch-scratch cycle.
Option D: If more moisturizing is required than a lotion can provide, a cream is recommended. These include Keri cream, Cetaphil cream, Eucerin cream, and Neutrogena Norwegian formula. Ointments are the most emollient. Vaseline Pure Petroleum Jelly or Aquaphor Natural Healing Ointment may be beneficial.
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