Wong's Essentials of Pediatric Nursing Practice Test 2026 - Free Pediatric Nursing Practice Questions and Study Guide

Intense itching from urticaria happens because bed bug saliva triggers an allergic reaction in the skin that releases histamine. This histamine irritates nerve endings and creates the familiar itchy sensation, along with raised welts. The itch is the hallmark feature of urticaria, so itching is the primary symptom you’d expect. A visible rash or welts can appear, but they’re secondary to the severe itch. Fever and nausea aren’t typical for a simple bed bug bite reaction, so they don’t fit as the main symptom.