A nurse is assessing a preschooler. Which of the following findings should indicate to the nurse a need for speech therapy? (Select all that apply)

Choice A reason:

Urinary hesitancy, while concerning, is not typically an immediate threat to the client’s health. It can indicate underlying issues such as benign prostatic hyperplasia (BPH) or urinary tract infections, which require medical attention but are generally not life-threatening. Addressing urinary hesitancy is important, but it does not take precedence over more acute conditions.

Choice B reason:

Swollen gums can be a sign of poor oral hygiene, gingivitis, or other dental issues. While important to address, swollen gums are not usually an immediate threat to the client’s overall health. Dental issues can lead to complications if left untreated, but they do not typically require urgent intervention.

Choice C reason:

Dysphagia, or difficulty swallowing, is a priority because it can lead to serious complications such as aspiration pneumonia, malnutrition, and dehydration. Aspiration pneumonia occurs when food or liquid enters the lungs, leading to infection. Dysphagia can also cause significant discomfort and impact the client’s ability to eat and drink adequately, making it a critical issue to address promptly.

Choice D reason:

Pruritus, or itching, can be a symptom of various conditions, including allergies, skin disorders, or systemic diseases such as liver or kidney problems. While pruritus can be very uncomfortable and impact the client’s quality of life, it is not typically an immediate threat to health. It requires assessment and management but is not as urgent as dysphagia.

Choice A reason: I would be happy to do whatever I can to help you. While this response shows empathy and a willingness to help, it does not address the fact that shopping for the client is outside the nurse’s job description. It is important for the nurse to adhere to professional boundaries and find appropriate solutions within those limits.

Choice B reason: What I think you should do is wait for the days when you feel better and do your grocery shopping then. This response is not practical or supportive. It does not provide a solution for the client’s immediate needs and may come across as dismissive of her current difficulties.

Choice C reason: I won’t be able to shop for you today because I have to get home to my family. This response is honest but lacks empathy and does not offer any alternative solutions. It may leave the client feeling unsupported and frustrated.

Choice D reason: Let’s look at some other resources to solve this problem. This response is the most appropriate as it acknowledges the client’s needs and seeks to find a solution within the nurse’s professional boundaries. The nurse can help the client explore options such as grocery delivery services, community resources, or assistance from family and friends.