A nurse is admitting a child who has pertussis. Which of the following isolation precautions should the nurse initiate?

Choice A rationale Droplet precautions are required for pertussis, also known as whooping cough, because the causative agent, Bordetella pertussis, is transmitted through respiratory droplets. These droplets are generated when the infected person coughs, sneezes, or talks, and they typically travel a short distance, usually around three to six feet, before settling. This requires a private room and the use of a mask within this distance. Choice B rationale Contact precautions are used for infections transmitted through direct or indirect contact with the patient or their environment, such as Clostridium difficile or methicillin-resistant Staphylococcus aureus (MRSA). While pertussis can be spread through contact with contaminated droplets on surfaces, the primary mode of transmission is droplet, not contact. Therefore, contact precautions alone would not be sufficient. Choice C rationale Airborne precautions are used for diseases transmitted by small droplet nuclei that can remain suspended in the air for extended periods and travel long distances, such as measles, tuberculosis, or varicella. While pertussis is a respiratory illness, its droplets are too large to remain airborne for long distances, making droplet precautions the more appropriate and specific intervention. Choice D rationale A protective environment is a type of isolation used for patients who are severely immunocompromised and at high risk of infection, such as those undergoing chemotherapy or stem cell transplantation. This environment minimizes the risk of hospital-acquired infections by filtering the air. Pertussis is a communicable disease, not a condition requiring immune protection for the patient.