A home health nurse is providing teaching to the guardian of a preschooler who is neutropenic. Which of the following instructions should the nurse include?

Neutropenia in a preschooler results from a decreased absolute neutrophil count, often due to conditions such as chemotherapy or bone marrow suppression. This significantly increases the child’s risk for infection because the immune system cannot effectively fight bacterial and fungal pathogens. Nursing care focuses on strict infection prevention strategies, including hygiene measures, environmental precautions, and dietary safety. Education for caregivers is essential to reduce exposure to infectious agents at home. Rationale: A. Allowing the child to have frequent playdates is inappropriate because neutropenic children should avoid exposure to large groups of people who may carry infectious organisms. Close contact with peers increases the risk of transmission of viral and bacterial infections. Social interactions should be limited or carefully controlled based on the child’s neutropenic status. B. Providing the child with a soft toothbrush is appropriate because it helps maintain oral hygiene while minimizing trauma to the gums and oral mucosa. This reduces the risk of mucosal breakdown, which can serve as an entry point for infection. Gentle oral care is a key infection prevention strategy in neutropenic patients. C. Encouraging the child to eat fresh vegetables is unsafe because raw fruits and vegetables may carry bacteria or parasites that pose a serious infection risk in immunocompromised children. A neutropenic diet typically involves avoiding raw or undercooked foods and ensuring all food is thoroughly washed and cooked. D. Bathing the child every other day is not the priority recommendation and may be insufficient for maintaining optimal hygiene in a neutropenic child. Over-bathing can dry the skin, but daily gentle bathing is often encouraged to reduce microbial load on the skin. Infection prevention requires consistent hygiene practices rather than reduced bathing frequency.