What is the appropriate next step for a 1-year-old male with elevated lead levels on a capillary blood test?

In the case of a 1-year-old male with elevated lead levels identified through a capillary blood test, the appropriate next step is to perform a confirmatory venous lead measurement. A capillary blood test can sometimes yield false positives due to contamination or other factors, making it essential to confirm elevated levels through a more accurate venous blood draw. The venous lead measurement is considered the gold standard for diagnosing lead poisoning, as it provides a more reliable assessment of the child's blood lead level.

This step is crucial in guiding further management and interventions. If the venous lead level is confirmed to be elevated, appropriate actions such as monitoring, dietary recommendations, or chelation therapy can then be considered based on the severity of the exposure and the level detected. In contrast, options that suggest reassessing dietary intake, immediate chelation therapy, or mere observation without confirmatory testing would not address the need for accurate diagnosis before proceeding with any form of treatment or management strategy.