Which of the following statements should the nurse teach the neutropenic client and his family to avoid?
A. Performing oral hygiene after every meal
B. Using suppositories or enemas
C. Performing perineal hygiene after each bowel movement
D. Using a filter mask
Correct Answer: B. Using suppositories or enemas
Neutropenic clients are at risk for infection especially bacterial infection of the gastrointestinal and respiratory tract. An incorrectly administered enema can damage tissue in your rectum/colon, cause bowel perforation and, if the device is not sterile, infections.
Option A: Performing oral hygiene consistently after meals could help prevent infection of the oral mucous membranes. Recommend the use of soft-bristled toothbrushes and stool softeners to protect mucous membranes. Hard-bristled toothbrushes can compromise the integrity of the mucous membrane and provide a port of entry for pathogens.
Option C: Proper perineal hygiene helps prevent urinary tract infections. Wash hands or perform hand hygiene before having contact with the patient. Also impart these duties to the patient and their significant others. Friction and running water effectively remove microorganisms from hands. Washing between procedures reduces the risk of transmitting pathogens from one area of the body to another.
Option D: Wearing a mask, especially in a crowded place, would help prevent contagious respiratory infections. Provide surgical masks to visitors who are coughing and provide rationale to enforce usage. Instruct visitors to cover mouth and nose (by using the elbows to cover) during coughing or sneezing; use of tissues to contain respiratory secretions with immediate disposal to a no-touch receptacle; perform hand hygiene afterward.