Integumentary Disorders Q 29

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Nurse Tamara discovers scabies when assessing a client who has just been transferred to the medical-surgical unit from the day surgery unit. To prevent scabies infection in other clients, the nurse should:

  

    A. Wash hands, apply a pediculicide to the client’s scalp, and remove any observable mites.

    B. Isolate the client’s bed linens until the client is no longer infectious.

    C. Notify the nurse in the day surgery unit of a potential scabies outbreak.

    D. Place the client on enteric precautions.

    

    

Correct Answer: B. Isolate the client’s bed linens until the client is no longer infectious.

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To prevent the spread of scabies in other hospitalized clients, the nurse should isolate the client’s bed linens until the client is no longer infectious — usually 24 hours after treatment begins. Teach the patient, family, and caregivers, the purpose and proper technique for maintaining isolation; if infection occurs, teach the patient to take antibiotics as prescribed. Instruct the patient to take the full course of antibiotics even if symptoms improve or disappear.

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Option A: Other required precautions include using good hand-washing technique and wearing gloves when applying the pediculicide and during all contact with the client. Wash hands and teach the patient and SO to wash hands before contact with patients and between procedures with the patient.

Option C: Although the nurse should notify the nurse in the day surgery unit of the client’s condition, a scabies epidemic is unlikely because scabies is spread through skin or sexual contact. Bedding, clothing, and towels used by infected persons or their household, sexual, and close contacts anytime during the three days before treatment should be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours.

Option D: This client doesn’t require enteric precautions because the mites aren’t found on feces. Monitor status of skin around the wound; monitor patient’s skincare practices, noting the type of soap or other cleansing agents used, the temperature of the water, and frequency of skin cleansing; tell the patient to avoid rubbing and scratching; provide gloves or clip the nails if necessary.

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