Child A 10am: 4-year-old presents with honey-colored crusted lesions around the nose and mouth Mild itching Lesions are superficial and moist BP 100/60, HR 107, RR 22, Temp 98.6F (37C), 98% Sp02 Capillary refill <2 seconds Patient is alert and active Provider diagnoses patient with impetigo. 11am: Nurse administers Bactroban topically as prescribed 12pm: BP 104/62, HR 104, RR 21, Temp 98.5F (37C), 98% Sp02 Capillary refill < 2 seconds Patient is alert and active 2pm: MD orders regular diet MD orders discharge for patient Which discharge instructions should the nurse include? SELECT ALL THAT APPLY:

A. It is okay to share towels if washed daily: Sharing towels, even if washed, can still transmit Staphylococcus aureus or Streptococcus pyogenes, the bacteria responsible for impetigo. Emphasizing individual towels and proper hand hygiene is crucial to prevent spreading the infection to household members or classmates. B. Stop antibiotics once erythema improves: Topical or systemic antibiotics must be completed for the full prescribed course, even if the lesions appear resolved. Premature discontinuation can result in incomplete bacterial eradication, recurrence, or development of antibiotic-resistant strains. C. Monitor for fever: Fever may indicate that the local skin infection is progressing to a systemic infection or that a secondary bacterial complication is developing. Parents should be instructed to observe for fever, malaise, or spreading redness and seek medical attention promptly if these occur. D. Engage in close contact activities: Close contact can facilitate transmission of impetigo to other children, especially in daycare or school settings. Children should avoid activities like sports or sharing toys until lesions are fully healed and covered to reduce the risk of spreading the infection. E. Avoid scratching the affected areas: Scratching impetigo lesions can introduce bacteria deeper into the skin, increasing the risk of cellulitis, secondary infection, or scarring. Keeping nails short and clean, and using gentle hygiene practices, helps protect the skin and promote healing.