Which parasitic infection should the nurse suspect in a child who scratches in the rectal area and has poor sleep?

The symptoms of scratching in the rectal area combined with poor sleep in a child strongly suggest an infection with pinworms. Pinworms, or Enterobius vermicularis, are known for causing intense itching around the anus, particularly at night when the female worms emerge to lay their eggs. This nocturnal itching can lead to significant discomfort, resulting in poor sleep quality for children.

The life cycle of pinworms includes the ingestion of eggs, which then hatch in the intestines. The female worms then migrate to the anal area to deposit their eggs, which often causes the characteristic itching. Scratching the affected area can lead to additional complications such as secondary bacterial infections and further spread of the eggs.

In contrast, roundworms typically do not cause anal itching and can present with abdominal pain or gastrointestinal symptoms. Hookworms primarily affect individuals through skin penetration, leading to different clinical manifestations such as anemia and gastrointestinal issues. Tapeworm infections may present with weight loss or nutritional deficiencies but are less likely to cause any direct symptoms like rectal itching. Therefore, the overall clinical picture aligns most closely with a pinworm infection, highlighting it as the most likely cause given the child's symptoms.