A nurse is checking a school-age child for pediculosis capitis. Which of the following findings is a definitive indication of this condition?

A. "Take a hot shower daily to relieve itching."

This instruction is not recommended because hot water can exacerbate itching and worsen the condition. Hot showers can strip the skin of its natural oils, leading to further dryness and irritation, which may aggravate the itching associated with scabies.

B. "Wear loose fitting clothing while you are experiencing itching."

This instruction is appropriate because loose-fitting clothing can help minimize friction and irritation on the skin affected by scabies. Tight clothing can exacerbate itching and discomfort, so wearing loose clothing can provide relief and allow the skin to breathe.

C. "Add fabric softener to linens when they are washed."

This instruction is not recommended because fabric softeners may contain chemicals or fragrances that can irritate the skin, especially for someone with pruritus or scabies. It's best to use gentle, fragrance-free laundry detergent to wash linens and clothing to minimize potential irritation.

D. "Use a soft bristle brush to gently rub the affected areas."

This instruction is not recommended because using a brush, even if it has soft bristles, can further irritate the skin and potentially spread the scabies mites to other areas of the body. It's best to avoid any abrasive or vigorous rubbing of the affected areas and instead focus on gentle cleansing and moisturizing techniques.

A. Gross hematuria: Gross hematuria refers to visible blood in the urine, which can present as pink, red, or cola-colored urine. While hematuria can be associated with various kidney conditions, including Wilms' tumor, it is not a consistent or defining symptom of this specific tumor. Additionally, because the tumor is typically confined within the kidney and does not usually invade the urinary tract, gross hematuria might not always be present.

B. Dysuria: Dysuria is the medical term for painful or difficult urination. It is not a typical symptom of Wilms' tumor, as this tumor primarily affects the kidney and may not directly affect the urinary tract in a way that causes painful urination.

C. An abdominal mass: This is the correct answer. Wilms' tumor often presents as a palpable abdominal mass, which may be felt during physical examination. The mass is usually firm, non-tender, and confined to one side of the abdomen. Detection of an abdominal mass should prompt further diagnostic evaluation to confirm the diagnosis and plan appropriate treatment.

D. Nausea and vomiting: While some children with Wilms' tumor may experience nausea and vomiting, these symptoms are nonspecific and can be caused by various conditions. They are not considered characteristic or defining features of Wilms' tumor. The presence of nausea and vomiting would prompt further assessment to determine the underlying cause