A nurse is assisting with the admission of a child who has measles. Which of the following isolation precautions should the nurse initiate?

Choice A: This statement indicates a lack of understanding of the teaching, as insulin should not be stored in the freezer, as freezing can damage the insulin and make it ineffective. Insulin should be stored in a cool and dry place, away from direct sunlight and heat sources. Unopened bottles of insulin can be stored in the refrigerator until their expiration date, but opened bottles of insulin can be kept at room temperature for up to 28 days.

Choice B: This statement indicates a lack of understanding of the teaching, as the morning blood glucose level for a child who has type 1 diabetes mellitus should be between 70 and 110 mg/dL, according to the American Diabetes Association. A blood glucose level between 90 and 130 mg/dL may indicate hyperglycemia, which is high blood sugar and can cause symptoms such as thirst, hunger, fatigue, or frequent urination. A blood glucose level below 70 mg/dL may indicate hypoglycemia, which is low blood sugar and can cause symptoms such as sweating, shaking, dizziness, or confusion.

Choice C: This statement indicates an understanding of the teaching, as eating a snack half an hour before playing soccer can help prevent hypoglycemia, which is low blood sugar, in a child who has type 1 diabetes mellitus. Physical activity can lower blood sugar levels by increasing the uptake of glucose by the muscles. Eating a snack that contains carbohydrates and protein can provide energy and prevent a sudden drop in blood sugar levels during or after exercise.

Choice D: This statement indicates a lack of understanding of the teaching, as regular insulin should not be skipped or stopped when a child who has type 1 diabetes mellitus is sick. In fact, insulin may need to be increased or adjusted when a child is sick, as illness can raise blood sugar levels by causing stress hormones or inflammation. The child should monitor their blood sugar levels more frequently when they are sick and follow their sick day plan that includes taking insulin, checking for ketones, staying hydrated, and contacting their provider if needed.

Choice A: This action is not appropriate, as it may cause more harm than good to separate the child from the parents without sufficient evidence or reason. Separating the child from the parents can cause fear, anxiety, or resentment in both parties and may interfere with establishing rapport and trust. The nurse should only separate the child from the parents if there is an immediate threat or danger to the child's safety.

Choice B: This action is premature, as it may violate confidentiality and ethical principles to report suspected abuse to the authorities without sufficient evidence or reason. Reporting suspected abuse to the authorities can have serious legal and social consequences for both parties and may escalate or worsen the situation. The nurse should only report suspected abuse to the authorities if there is clear evidence or indication of abuse or if mandated by law.

Choice C: This action is irrelevant, as it may not address the issue or help resolve it to ask a psychiatrist to talk with the parents without sufficient evidence or reason. Asking a psychiatrist to talk with the parents can imply that they have mental health problems or that they are guilty of abuse, which can cause stigma, anger, or denial. The nurse should only ask a psychiatrist to talk with the parents if there is evidence or indication of mental health problems or if requested by them.

Choice D: This action is appropriate, as it can help determine whether there is any evidence or reason to suspect abuse or not. Obtaining a detailed history can provide information about how, when, where, and why the bruises occurred and whether they are consistent with accidental or intentional injury. The nurse should obtain a detailed history from both parties separately and in a nonjudgmental and supportive manner.