A nurse is reviewing discharge instructions with a client who has pruritus following treatment for scabies. Which of the following instructions should the nurse include?

A. Adhere to strict dietary reduction of oily foods:

Dietary changes, particularly reducing oily and greasy foods, are often recommended as a measure to manage acne. However, the evidence supporting this recommendation is mixed, and strict dietary restrictions may not be necessary for all individuals with acne. Therefore, while the nurse might mention the potential impact of diet on acne, strict dietary reduction of oily foods is not typically the primary focus of acne treatment.

B. Express the larger comedones periodically:

Expressing or squeezing comedones (blackheads or whiteheads) can lead to further inflammation, scarring, and infection. It is not recommended to express comedones at home without proper training and technique. Attempting to express comedones can exacerbate acne and may cause more harm than good.

C. Minimize sun exposure:

Sun exposure can worsen acne and lead to increased inflammation and hyperpigmentation. Therefore, it is important for individuals with acne to minimize sun exposure and use sunscreen with a broad-spectrum SPF of 30 or higher.

D. Use friction when washing the face:

Excessive friction or aggressive scrubbing when washing the face can irritate the skin and worsen acne. Instead, the nurse should advise gentle cleansing of the face using a mild, non-comedogenic cleanser and lukewarm water. Harsh scrubbing or using abrasive cleansers can disrupt the skin barrier and exacerbate acne symptoms.

A. Barley:

Barley is a grain that contains gluten. Foods made from barley, such as barley flour or barley-based products like bread, cereal, or beer, should be avoided by individuals with celiac disease because gluten can trigger an immune response that damages the small intestine.

B. Rye:

Similar to barley, rye is another grain that contains gluten. Foods made from rye, such as rye bread or rye-based cereals, should also be avoided by individuals with celiac disease because they can trigger adverse reactions due to gluten.

C. Rice:

Rice is a gluten-free grain and is safe for individuals with celiac disease to consume. It does not contain gluten proteins that can cause intestinal damage or trigger immune responses in those with gluten sensitivity or celiac disease.

D. Wheat:

Wheat is a major source of gluten and should be strictly avoided by individuals with celiac disease. Foods made from wheat, such as wheat bread, pasta, or baked goods, can lead to symptoms and intestinal damage in individuals with gluten intolerance or celiac disease.