Which of the following interventions would be implemented when caring for a 12 year old child with impetigo?

Impetigo is a highly contagious superficial bacterial skin infection, most commonly caused by Staphylococcus aureus or Streptococcus pyogenes. It spreads through direct contact and autoinoculation, producing honey-colored crusted lesions primarily in children. Infection control focuses on reducing transmission and preventing lesion spread.

Rationale:

A. Airborne precautions are not indicated because impetigo is transmitted via direct contact and fomites, not aerosolized particles. Standard or contact precautions are appropriate, not airborne isolation, making this option incorrect for infection control.

B. A child with impetigo remains contagious until 24 hours after effective antibiotic therapy begins. Lesions alone do not indicate non-contagious status, so teaching that the child is no longer infectious once the rash appears is incorrect and increases transmission risk.

C. Pain is not a predominant feature of impetigo, as lesions are usually superficial and mildly pruritic rather than painful. Antibiotic therapy addresses infection, but routine pain management is not a primary intervention unless complications occur.

D. Avoiding touching lesions reduces autoinoculation and transmission, which are key mechanisms in impetigo spread. Preventing scratching and hand-to-face contact is essential to limit dissemination to other body areas and reduce transmission to close contacts.

Non-accidental trauma in pediatrics is strongly associated with developmental mismatch injuries, especially in non-ambulatory infants. Abuse-related fractures often involve long bones, high-force mechanisms, and inconsistent history. Infants are at highest risk due to limited mobility and inability to generate sufficient force for major skeletal injury.

Rationale:

A. Humerus fractures in school-aged children are commonly accidental, typically resulting from falls, playground activity, or sports-related trauma. The injury pattern is consistent with developmental mobility, making abuse less likely in this age group.

B. Femur fractures in an infant require significant force not typically encountered in normal caregiving or accidental falls. This pattern is highly concerning for non-accidental trauma, especially when the child is not ambulatory, making abuse the most likely cause.

C. Radius fractures in preschool-aged children commonly occur from falls onto an outstretched hand during play. This is a typical accidental injury pattern, reflecting normal gross motor activity and does not strongly indicate inflicted trauma.

D. Elbow fractures in teenagers are frequently associated with sports injuries or high-energy falls. At this developmental stage, exposure to physical activity makes accidental mechanisms far more probable than abuse-related injury.