The mother of a 6-year-old girl is concerned about her child's obesity. The child's weight plots at the 75th percentile, and height at the 25th percentile. The child's body mass index (BMI) is at the 85th percentile for age and gender. Which intervention(s) should the nurse implement? Select all that apply.

Choice A reason: Obtaining the child's 3-day diet history based on the mother's input is a useful intervention to assess the child's nutritional intake and identify any unhealthy eating habits or patterns. The nurse can use the diet history to provide individualized and evidence-based dietary advice and counseling to the mother and the child, such as reducing the intake of sugar-sweetened beverages, increasing the intake of fruits and vegetables, and limiting the portion sizes. Choice B reason: Explaining that the child is likely to grow into her weight is not a helpful intervention and may be misleading or harmful. It may give the mother and the child a false sense of reassurance and discourage them from making any lifestyle changes. It may also ignore the potential health risks and psychosocial consequences of childhood obesity, such as diabetes, hypertension, low self-esteem, and bullying. Choice C reason: Telling the mother that girls hit their growth spurt before boys so eating more is expected is not a valid intervention and may be inaccurate or inappropriate. It may imply that the child's obesity is normal or inevitable, which is not true. It may also overlook the fact that the child's weight and height are disproportionate and do not match the growth charts for her age and gender. Choice D reason: Inquiring as to whether or not the school has a physical education program is not a sufficient intervention and may be irrelevant or ineffective. It may not address the child's specific physical activity needs and preferences, or the barriers and facilitators to physical activity in the home and community settings. It may also shift the responsibility and accountability from the mother and the child to the school. Choice E reason: Determining the child's usual physical activity pattern is a beneficial intervention to evaluate the child's energy expenditure and identify any sedentary behaviors or activities. The nurse can use the physical activity pattern to provide individualized and evidence-based physical activity recommendations and guidance to the mother and the child, such as increasing the frequency, intensity, and duration of moderate to vigorous physical activity, reducing the screen time, and engaging in fun and enjoyable physical activities..