Which nursing intervention is most effective in preventing further excoriation in a 2-year-old with severe eczema?

The most effective intervention for preventing further excoriation in a 2-year-old with severe eczema involves placing elbow restraints on the child's arms. This method limits the child's ability to bend their elbows, which effectively prevents them from reaching their affected skin areas to scratch. Scratching can significantly worsen the condition by causing additional irritation, allowing bacteria to enter the skin, and potentially leading to infections.

The rationale for using elbow restraints is based on their non-intrusive nature and targeted effectiveness; they provide a constructive way to protect the child's skin while still allowing some range of movement. This is especially important in young children, who may not understand the need to refrain from scratching. Maintaining comfort and preventing further damage to the skin are crucial in managing eczema effectively.

Utilizing gloves or finger cots may provide a temporary solution, but these methods can be less effective since children can still access their skin, especially in the areas that need protection. Soft restraints on the wrists might also prevent some movement, but they do not specifically restrict elbow motion, which remains critical in managing the behavioral component of itching and scratching that young children often exhibit.