A nurse is assessing the social determinants of health for community members. Which of the following factors should the nurse identify as part of the neighborhood and built environment?

• Client 1: This client has a minor laceration with minimal drainage and stable vital signs. No signs of shock or infection are present. This injury is not life-threatening and can wait, making this client a low-priority (green-tag) case.
• Client 2: Although this client is experiencing worsening pain and signs of mild hypovolemia, they are alert and have stable vital signs. This client needs prompt care, but not immediate life-saving interventions, making them a delayed (yellow-tag) priority.
• Client 3: The client has a mild head injury with stable neurological signs and no evidence of increased intracranial pressure or altered consciousness. This presentation does not require immediate intervention and would also be triaged as delayed.
• Client 4: This client presents with signs of severe traumatic brain injury—fixed pupils, decorticate posturing, and irregular respirations—which indicate brainstem dysfunction. Although the prognosis is poor, the condition is immediately life-threatening and requires urgent airway and neurological support, making this client a top priority (red-tag).
• Client 5: This client has an open fracture and reports significant pain but has stable vital signs and adequate circulation. The injury requires treatment but is not immediately life-threatening, so they can be managed later (yellow-tag).
• Client 6: The client shows signs of progressing respiratory distress—tripod positioning, retractions, anxiety, and diminished breath sounds—indicating possible airway compromise from inhalation injury. This is an urgent, potentially fatal condition requiring immediate airway management (red-tag).

A. Maintain a BMI between 28 and 32: A healthy BMI range is typically 18.5 to 24.9. A BMI of 28–32 is considered overweight or obese, which increases the risk for cardiovascular disease, diabetes, and joint problems. Therefore, this is not a recommended target for older adults.

B. Participate in weight-bearing exercises: Weight-bearing activities, such as walking or light strength training, help maintain bone density and prevent osteoporosis. They also support mobility, balance, and cardiovascular health in older adults.

C. Complete a lead poisoning screening every two years: Lead screening is generally targeted toward children or adults at occupational risk. Routine screening for lead poisoning is not recommended for older adults unless specific exposure risk is identified.

D. Receive an influenza vaccine every year: Yearly influenza vaccination is recommended for older adults due to their increased risk of complications from flu infections. It is a key component of preventive care.

E. Limit alcohol to no more than one drink per day or four per week: Older adults metabolize alcohol differently and are more sensitive to its effects. Limiting intake as recommended reduces the risk of falls, liver damage, and interactions with medications.