An adult client receives a prescription for permethrin (Acticin Cream 5%) to treat an infestation of scabies. The nurse instructs the client to massage the cream into the skin from the head to the soles of the feet, avoiding the eyes. Which additional instruction should the nurse provide?
A.
Remove the cream from the skin immediately if pruritis occurs.
B.
Reapply cream in seven days to prevent re-infestation.
C.
Shower or bathe 8 to 14 hours after treatment to remove cream.
D.
Avoid areas between fingers and toes during application.
The correct answer and Explanation is :
The correct answer is C. Shower or bathe 8 to 14 hours after treatment to remove cream.
Explanation:
Permethrin cream (Acticin Cream 5%) is a topical medication used to treat scabies, an infestation of the skin by the Sarcoptes scabiei mite. The medication works by killing the mites and their eggs. Proper application and removal of the cream are crucial for its effectiveness and for minimizing potential side effects.
- Application Instructions:
The nurse’s instruction to apply the cream from the head to the soles of the feet, avoiding the eyes, is correct. The cream should cover all affected areas, including the skin folds, between fingers and toes, and under the nails. It is important to ensure the entire body is treated to effectively eradicate the mites. - Removal of Cream:
Permethrin cream should be left on the skin for 8 to 14 hours. During this time, it is important not to bathe or shower, as this could remove the cream before it has had a chance to work. After the recommended period, the client should shower or bathe to remove the cream thoroughly. This step is crucial because it helps to clear the dead mites and eggs from the skin while ensuring that any remaining medication is washed off, reducing the risk of skin irritation. - Additional Considerations:
- Avoiding areas between fingers and toes during application is not recommended; these areas need treatment to fully eliminate the infestation.
- Reapplication in seven days is generally not necessary unless the scabies infestation is severe or persists, as a single application is usually effective.
- Removing the cream immediately if pruritis occurs is not advised because pruritis can be a normal reaction and doesn’t necessarily indicate that the cream should be removed. Instead, the client should be advised to follow the treatment guidelines and consult with their healthcare provider if the reaction is severe or persistent.
In summary, instructing the client to shower or bathe 8 to 14 hours after the application is the correct guidance to ensure the effectiveness of the treatment and to minimize potential side effects.