Which client is at the greatest risk for infection?

The client on total parenteral nutrition (TPN) via a central line is at the greatest risk for infection due to several factors associated with this type of therapy. When a client is receiving TPN, they are typically in a state of altered nutritional support, which can compromise their immune system. A central line, while necessary for administering TPN, introduces a direct entry point into the bloodstream, increasing the likelihood of a bloodstream infection (central line-associated bloodstream infection, or CLABSI).

Additionally, TPN solutions are nutrient-rich and can provide an ideal environment for bacterial growth if not managed properly. The sterile technique required during the insertion and maintenance of the central line is crucial to minimize infection risk. TPN patients often have weakened immune responses, further exacerbating the potential for infection.

While other clients mentioned may also have risk factors for infection, such as the immunosuppressive effects of methylprednisolone or the potential complications from an external urinary catheter, the combination of the invasive central line and the nature of TPN therapy places the central line recipient at the highest risk overall.