A nurse in a mobile health clinic is caring for a client who requires an immunization and does not speak the same language as the nurse. Which the following actions should the nurse take first?

• Client 1: Streptococcus pyogenes (Group A Streptococcus) infections, especially with symptoms suggestive of pharyngitis, are reportable to public health authorities due to their potential to cause outbreaks and complications such as rheumatic fever. National notification helps in tracking and controlling the spread.
• Client 2: Elevated blood lead levels in children are a significant public health concern and require mandatory reporting for environmental intervention and follow-up. Lead poisoning can cause serious developmental problems, so this case must be reported.
• Client 3: Herpes zoster (shingles) is not a nationally notifiable condition. Although it is contagious to individuals who have not had varicella or the vaccine, it does not require public health notification.
• Client 4: Tuberculosis is a highly contagious and serious infectious disease that is nationally notifiable. Positive tuberculin skin test results combined with symptoms consistent with active disease require reporting for public health surveillance and intervention.
• Client 5: Chlamydia is a common sexually transmitted infection that is nationally notifiable. Reporting allows for partner notification, treatment, and prevention of further transmission, even if the client is asymptomatic.

A. Identify the client's spoken dialect: Knowing the specific dialect is important for selecting an appropriate interpreter, but this should be done after securing access to interpretation services. It is a secondary step following the identification of the communication barrier.

B. Document the use of the interpreter: Documentation is a necessary legal and clinical step after care has been provided. It confirms communication occurred appropriately but is not the first priority when initiating communication.

C. Talk directly to the client: While it is respectful and essential to engage with the client directly once interpretation is arranged, doing so without an interpreter risks miscommunication and may compromise informed consent and care quality.

D. Contact a qualified medical interpreter: The first action is to ensure accurate communication by accessing a trained medical interpreter. This ensures the client receives information in a language they understand, which is critical for safe and effective care.