A nurse is reinforcing teaching with a client who has HIV and is being discharged to home. Which of the following instructions should the nurse include in the teaching?

Choice A rationale Clients with HIV are immunocompromised and at high risk for opportunistic infections. Skin integrity is a primary defense mechanism. While daily hygiene is necessary, the instruction to wash only the armpits and genitals is insufficient for infection prevention. A full daily bath or shower using a mild antimicrobial soap is usually recommended to reduce the bacterial load on the entire skin surface, thereby decreasing the risk of pathogens entering through micro-abrasions or sores. Choice B rationale Monitoring for fever is a critical component of self-care for a client with HIV. A temperature elevation is often the first sign of an underlying infection or an opportunistic process. The client should be taught to take their temperature at least once daily and report any increase above 38 C or 100.4 F to their healthcare provider immediately. Early detection of infection allows for prompt diagnostic testing and initiation of appropriate antimicrobial or antiviral therapy. Choice C rationale Hygiene in the kitchen is vital for preventing foodborne illnesses, which can be fatal for someone with a low CD4 count. However, washing dishes in "warm" water is inadequate to kill many pathogens. The nurse should instruct the client to use a dishwasher on a high-heat setting or to wash dishes in hot, soapy water followed by air-drying. Alternatively, using disposable plates and utensils can further minimize the risk of cross-contamination from improperly cleaned surfaces. Choice D rationale Toxoplasmosis is a significant opportunistic infection caused by the parasite Toxoplasma gondii, which is commonly shed in the feces of infected cats. While wearing gloves offers some protection, the safest recommendation for an immunocompromised client is to avoid changing litter boxes entirely. If they must do it, they should wear gloves and a mask and wash their hands thoroughly afterward. However, delegating this task to a household member is the preferred safety intervention.