A nurse is creating a plan of care for an immunosuppressed client. Which of the following precautions should the nurse include in the plan?

Choice A rationale Immunosuppressed clients have a diminished ability to mount an immune response against pathogens due to low white blood cell counts, particularly neutrophils. Restricting visitors with active infections, such as colds, flu, or skin lesions, is a critical primary prevention strategy. Since the client's natural defenses are compromised, exposure to even minor viruses or bacteria from others can lead to life-threatening systemic infections or sepsis that the client's body cannot fight. Choice B rationale Disposing of all linen in the trash is not a standard precaution for immunosuppression and is neither cost-effective nor necessary for infection control. Standard hospital protocols involve placing soiled linens in designated laundry bags for high-temperature commercial laundering, which effectively kills pathogens. This choice does not align with evidence-based practices for neutropenic precautions, as the focus should be on preventing the introduction of new pathogens to the client rather than discarding fabric. Choice C rationale Raw fruits and vegetables can harbor soil-borne bacteria, molds, and fungi like Pseudomonas or Aspergillus that are difficult to wash away completely. For a severely immunocompromised individual, these organisms can cause opportunistic infections. Instructing the client to eat only thoroughly cooked foods ensures that heat has destroyed potential pathogens. This low-microbial diet is a common component of protective environment protocols to minimize the risk of foodborne illness while the immune system is weak. Choice D rationale Daily bathing is actually encouraged for immunosuppressed clients to reduce the microbial load on the skin. The skin is the body's first line of defense, and maintaining its integrity and cleanliness helps prevent the overgrowth of normal flora that could become pathogenic if they enter the bloodstream through small nicks or IV sites. Limiting hygiene would increase the risk of skin-related infections and the accumulation of potentially harmful bacteria on the body surface. Choice E rationale The use of personal protective equipment, including a mask, gloves, and a gown, is part of protective or reverse isolation. This creates a physical barrier between the staff and the vulnerable client to prevent the transmission of microorganisms from the environment or healthcare workers to the patient. While standard precautions protect the nurse, these specific measures in an immunosuppressed context serve to shield the patient from outside contaminants during direct care and procedures.