The home health nurse is visiting an older client who was discharged from the hospital 3 days ago following hip pinning surgery. The client lives with her daughter, who prepares the family meals. In discussing nutrition for postoperative healing, which food choices should the nurse suggest for this client's diet? (Select all that apply.)

Choice A

Soft low-residue diet should not be recommended. This diet is often used for individuals with gastrointestinal issues and aims to reduce the bulk and frequency of bowel movements. It might not be necessary for this client's dental concerns.

Choice B

Pureed diet should not be recommended. A pureed diet involves blending foods to a smooth consistency, which is often recommended for individuals with severe difficulty swallowing or chewing. Since the client has no teeth but doesn't necessarily have difficulty swallowing, a pureed diet might be overly restrictive.

Choice C

Mechanical soft diet should not be recommended. mechanical soft diet consists of foods that are easy to chew and swallow, making it suitable for individuals with dental issues or difficulty chewing. It includes foods that are softer in texture, often cooked until they are tender and easy to manipulate with a fork or spoon. This type of diet would be beneficial for the client in question, as it accommodates his lack of teeth and ensures that he can consume a variety of foods without the need for extensive chewing.

Choice D

Full liquid diet should be recommended. A full liquid diet includes foods in liquid form, such as soups, milk, and juice. While it's easy to swallow, it might not provide the necessary variety and texture for the client's nutritional needs.

Choice A

Cutting the spaghetti and meatballs into small pieces is inappropriate. This choice is not directly related to the risk of infection. It might be helpful for a client who has difficulty swallowing or chewing, but it doesn't address the compromised immune system and infection risk.

Choice B

Exchanging pasteurized whole milk with skim milk is inappropriate. The type of milk doesn't have a direct impact on infection risk. Both pasteurized whole milk and skim milk are considered safe for consumption. This choice doesn't address the specific concern of infection in a client with a low ANC.

Choice C

Substituting fried potatoes with a garden salad is inappropriate. While choosing healthier food options can be beneficial for overall health, the choice between fried potatoes and a garden salad doesn't necessarily impact the infection risk for a client with a low ANC. This choice also doesn't address the specific concern of infection in this context.

Choice D

Remove the fresh grapes from the meal tray is appropriate. The reason for this choice is that a client with an absolute neutrophil count (ANC) of 400 has a significantly compromised immune system, and they are at a high risk of infection due to their low neutrophil count. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. A normal ANC falls within the range of 2500 to 8000 mm3 or cells/uL.

Fresh grapes, being a raw and uncooked food item, may carry a higher risk of containing bacteria or pathogens that could pose a threat to a client with such a low ANC. The nurse needs to ensure that the client's exposure to potential sources of infection is minimized.