The Somali parents bring their 1-year-old child to the ER of a large urban hospital. The child is lethargic and has bloody urine and blood seeping through a diaper. The child's parents do not speak English. Which intervention should the nurse implement first?

The nurse should first request an interpreter because parental consent is needed for assessment and treatment of the child. Most major health care facilities usually have an on-site interpreter or have made arrangements for on-demand remote video or telephone interpreting services. The BP is important to assess perfusion, but the parents may not allow the child to be touched without first communicating through an interpreter. Although blood seeping through the diaper and the fact that the parents are Somali may lead the nurse to think about female genital mutilation, there is no information to substantiate this. The genitalia may need to be inspected, but parental consent is needed first. Blood and urine cultures may need to be obtained to determine if the child has a UTI or is septic or dehydrated, but an interpreter is needed first to explain the tests to the parents.