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

Choice A reason: Tremors are not a likely finding in a child with hyperglycemia, or high blood glucose. Tremors are more commonly associated with hypoglycemia, or low blood glucose, as the body releases adrenaline to stimulate the release of glucose from the liver. Tremors may also be caused by anxiety, caffeine, or certain medications.

Choice B reason: Shallow respirations are not a likely finding in a child with hyperglycemia, unless the child has developed diabetic ketoacidosis (DKA), a serious complication of diabetes that occurs when the body breaks down fat for energy and produces ketones, which are acidic substances that can cause metabolic acidosis. In DKA, the child may have rapid and deep breathing, also known as Kussmaul respirations, as the body tries to eliminate excess carbon dioxide and acid. However, DKA usually occurs when the blood glucose level is above 300 mg/dL, and the child may also have other signs and symptoms, such as nausea, vomiting, abdominal pain, fruity breath, and confusion.

Choice C reason: Pallor is not a likely finding in a child with hyperglycemia, as the blood flow to the skin is not affected by high blood glucose. Pallor is more commonly associated with anemia, shock, or hypoxia, which are conditions that reduce the oxygen-carrying capacity of the blood or the blood flow to the tissues.

Choice D reason: Lethargy is a likely finding in a child with hyperglycemia, as high blood glucose can cause dehydration, electrolyte imbalance, and impaired brain function. The child may feel tired, weak, and drowsy, and have difficulty concentrating or staying awake. Lethargy may also indicate that the child is at risk of developing DKA, which can lead to coma and death if not treated promptly.

Choice A reason: Improved hydration is not a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Hydration status should be monitored for any child with a respiratory infection, but it does not reflect the severity of the airway inflammation.

Choice B reason: Decreased temperature is not a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Fever may or may not be present in this condition, and it does not correlate with the degree of airway obstruction.

Choice C reason: Decreased stridor is a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Stridor is a high-pitched sound caused by turbulent airflow through a narrowed upper airway. It indicates a significant obstruction that can compromise breathing. A reduction in stridor means that the airway inflammation has subsided and the child can breathe more easily.

Choice D reason: Barking cough is not a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Barking cough is a characteristic symptom of this condition, caused by the swelling of the vocal cords. It may persist for several days after the acute episode, even when the child is improving.