An 18-month-old patient was recently diagnosed with atopic dermatitis on the trunk and extensor surface of the arms and legs. The nurse practitioner initiated treatment with emollients, dietary precautions, and environmental control. The caregiver reports today that the child has been scratching the affected areas more frequently during the day and has been restless at night. The lesions appear erythematous without excoriation. The nurse practitioner should:

Rationale: A. Oral corticosteroids are generally reserved for severe, widespread, or refractory atopic dermatitis due to potential systemic side effects, and topical antihistamines are not routinely recommended because of limited efficacy and risk of skin reactions. B. A low-potency topical steroid applied three times daily helps reduce inflammation in mild to moderate atopic dermatitis while minimizing risk of skin atrophy. An oral antihistamine at bedtime can help control itching and improve sleep, addressing the patient’s restlessness at night. C. Medium-potency topical steroids are usually unnecessary for mild erythematous lesions without excoriation and increase the risk of adverse effects in toddlers. Topical antihistamines are generally avoided. D. Topical antibiotics are indicated only if there is evidence of secondary bacterial infection. Routine use in non-infected atopic dermatitis is not recommended. Oral antihistamines three times daily are not standard; bedtime dosing is preferred to reduce daytime sedation.