During an admission assessment, the nurse observes the presence of kyphosis on an older adult female client with a history of osteoporosis. Which action should the nurse take in response to this finding?

A. Suggest that the parent read aloud to the child at bedtime. Reading aloud to the child is a beneficial practice that can enhance language development, vocabulary, and communication skills. It provides the child with exposure to language in a meaningful context and can stimulate spontaneous speech.

B. Discuss with the parent the need for a hearing screening. A hearing screening is a prudent intervention as hearing issues can significantly impact speech development. Ensuring the child has normal hearing is a critical first step in addressing delayed speech. Once hearing issues are ruled out, reading aloud and other strategies can be more effectively implemented.

C. Recommend that the parent enroll the child in preschool. Enrolling the child in preschool can provide a language-rich environment and opportunities for social interaction, which can stimulate speech and language development. However, this may not be the first step without ruling out other issues like hearing problems.

D. Encourage the parent to tell the child to ask for what he wants. Encouraging the child to use words to express needs is helpful for language development. It promotes verbal communication and helps the child learn to articulate desires and needs. This strategy, combined with other interventions, can be effective.

A: Primary source of water. This assessment might be relevant if there is a concern about lead exposure or other contaminants in the water, which can contribute to anemia. Therefore, while important in certain contexts, it is not the most immediate assessment for these specific clinical manifestations.

B: Standard household income. Household income can influence access to nutritious food and overall health. Lower income can lead to food insecurity, poor diet quality, and subsequently, anemia and lower BMI due to inadequate nutrient intake. This can be an indirect but important factor to consider. However, it does not directly assess the child’s dietary intake or specific nutritional deficiencies.

C: Family history of eating disorders. Family history of eating disorders might provide insights into potential genetic or environmental predispositions to eating disorders. However, eating disorders are more commonly associated with adolescents and adults rather than school-age children.

D: Average daily intake of meals. This is the most directly relevant assessment. Analyzing the child's average daily intake of meals can provide immediate insights into potential nutritional deficiencies that might explain both the low hemoglobin level (anemia) and low BMI. Poor dietary intake, particularly of iron-rich foods, can lead to iron-deficiency anemia and inadequate caloric intake, affecting BMI. This assessment helps identify specific dietary issues that can be addressed directly to improve the child’s health.