A nurse is planning care for a client who is receiving chemotherapy and has neutropenia. Which of the following interventions should the nurse include in the plan?
A.
Avoid including raw fruits in the client’s diet.
B.
Restrict visits from young children to 2 hr per day.
C.
Measure the client’s temperature once per shift.
D.
Use disposable gloves from a box outside the client’s room.
The Correct Answer and Explanation is:
The correct answer is A. Avoid including raw fruits in the client’s diet.
Explanation:
Neutropenia is a condition characterized by an abnormally low number of neutrophils, a type of white blood cell critical to fighting infections. It commonly occurs in clients undergoing chemotherapy, as the treatment often suppresses bone marrow function, leading to reduced production of white blood cells. As a result, clients with neutropenia are highly susceptible to infections, making infection prevention a primary goal in their care.
- Avoiding raw fruits: Raw fruits, along with raw vegetables and unpasteurized products, can harbor bacteria and other pathogens that a neutropenic client may not be able to fight off. Including raw fruits in the diet increases the risk of exposure to these microorganisms, which can cause severe infections. By eliminating raw fruits, the nurse minimizes the risk of introducing potential pathogens, safeguarding the client’s compromised immune system.
- Restricting visits from young children (Option B): Although limiting exposure to potential infections is crucial, there is no specific recommendation about restricting visits to a set number of hours. Instead, children who are symptomatic (fever, cough, runny nose) or those with known infectious illnesses should be avoided. Visitors should also follow strict hand hygiene protocols.
- Measuring the client’s temperature once per shift (Option C): Frequent temperature monitoring is critical for early detection of infection, which can quickly become life-threatening in neutropenic clients. However, measuring the temperature only once per shift may not be sufficient. It should be checked more frequently, such as every 4 hours, especially if the client exhibits any signs of infection.
- Using disposable gloves from a box outside the client’s room (Option D): Standard infection control practices already include wearing gloves when providing care to protect both the client and healthcare workers. However, there is no specific requirement for gloves to be stored outside the room unless the client is under special isolation precautions. Proper hand hygiene before and after glove use is more critical than the location of the glove box.
In summary, the primary focus in caring for neutropenic clients is reducing exposure to potential pathogens. Avoiding raw fruits is a key intervention in reducing infection risk, along with proper hand hygiene, environmental cleanliness, and vigilant monitoring for signs of infection.