Which of the following is the correct way to write the date in the American format?

Choice A reason: A protective environment is a type of isolation precaution that is used for patients who are immunocompromised and at high risk of infection from environmental sources, such as fungi or bacteria. It involves using a private room with positive air pressure, high-efficiency particulate air (HEPA) filtration, and strict hand hygiene. It is not indicated for patients who have measles, as they are the source of infection, not the susceptible host.

Choice B reason: Airborne is a type of isolation precaution that is used for patients who have diseases that are transmitted by small droplets that can remain suspended in the air and travel over long distances, such as tuberculosis, chickenpox, or measles. It involves using a private room with negative air pressure, HEPA filtration, and respiratory protection for health care workers and visitors. It is the appropriate isolation precaution for patients who have measles, as it prevents the spread of the virus to others.

Choice C reason: Contact is a type of isolation precaution that is used for patients who have diseases that are transmitted by direct or indirect contact with the patient or their environment, such as Clostridioides difficile, scabies, or impetigo. It involves using a private room or cohorting with similar patients, wearing gloves and gowns, and using dedicated equipment. It is not indicated for patients who have measles, as the disease is not spread by contact.

Choice D reason: Droplet is a type of isolation precaution that is used for patients who have diseases that are transmitted by large droplets that are generated by coughing, sneezing, or talking, such as influenza, pertussis, or meningitis. It involves using a private room or cohorting with similar patients, wearing a surgical mask, and maintaining a distance of at least 3 feet from the patient. It is not indicated for patients who have measles, as the disease is spread by airborne transmission.

Choice A reason: Discouraging a high level of fluid intake is incorrect, as hydration is essential for preventing sickle cell crises and reducing blood viscosity. The nurse should encourage the child to drink at least 1.5 times the normal fluid requirement.

Choice B reason: Administering meperidine every 4 hr for pain is incorrect, as meperidine is not recommended for sickle cell pain due to the risk of neurotoxicity and seizures. The nurse should use other opioids such as morphine or hydromorphone for pain management.

Choice C reason: Applying cold compresses to painful, swollen joints is incorrect, as cold can cause vasoconstriction and worsen the sickling of red blood cells. The nurse should use warm compresses or heating pads to promote vasodilation and blood flow.

Choice D reason: Observing for indications of hypokalemia is correct, as sickle cell anemia can cause hemolysis and potassium loss. The nurse should monitor the child's serum potassium level and watch for signs of hypokalemia such as muscle weakness, cramps, arrhythmias, and constipation.