A nurse is teaching a client undergoing chemotherapy about infection prevention strategies. Which instructions should the nurse include? (Select All that Apply.)

A. Although fruits and vegetables are typically part of a healthy diet, clients receiving chemotherapy often experience neutropenia, which significantly increases their risk of infection. Raw fruits and vegetables can harbor bacteria, parasites, or fungi if not properly washed or prepared. In some cases, clients are advised to follow a neutropenic diet, which may limit raw produce and instead encourage cooked or thoroughly cleaned foods to reduce microbial exposure. B. Sharing towels or personal hygiene items can transmit microorganisms such as bacteria and fungi. Because chemotherapy suppresses the immune system, even minor exposures can lead to serious infections. Clients should use individual personal items and maintain strict hygiene practices. C. A temperature of 100.4°F (38°C) or higher is considered a medical emergency in clients undergoing chemotherapy. Due to reduced white blood cell counts, the body may not mount a typical immune response, making fever one of the earliest and sometimes only signs of infection. Prompt reporting allows for immediate evaluation and initiation of antibiotics if needed, which can be life-saving. D. Frequent and proper hand hygiene is the single most effective method to prevent infection. It reduces the transmission of pathogens from contaminated surfaces, other individuals, and the client’s own body. Clients should wash hands before eating, after using the restroom, after touching public surfaces, and after contact with others. E. Avoiding large crowds and people who are ill minimizes exposure to infectious agents. Clients undergoing chemotherapy have weakened immune defenses and are more susceptible to infections that would otherwise be mild in healthy individuals. This precaution is especially important during peak illness seasons or outbreaks. F. Live vaccines contain weakened forms of pathogens and can cause disease in immunocompromised individuals. Clients receiving chemotherapy should avoid live vaccines unless specifically directed by their healthcare provider. Inactivated vaccines may be considered, but timing is important. G. Avoiding hand hygiene would greatly increase the risk of infection. Proper hygiene is essential for preventing illness in immunocompromised clients.