Final answer:
The priority nursing diagnosis for a client with primary immunodeficiency should be 'Risk for infection related to altered immune cell function' due to their significantly increased susceptibility to infections.
Step-by-step explanation:
When developing a plan of care for a client with a primary immunodeficiency, the priority nursing diagnosis should be a) Risk for infection related to altered immune cell function. This is because individuals with primary immunodeficiencies have a compromised immune system, often resulting from genetic defects affecting elements of innate or adaptive immunity, making them more susceptible to infections. A client with conditions such as chronic granulomatous disease, X-linked agammaglobulinemia, or severe combined immunodeficiency disease, will have an increased risk of infection due to the inability of the immune system to function properly. This priority is chosen over other concerns like impaired skin integrity, anxiety, and grieving due to the immediate and potentially life-threatening nature of infections in these individuals.
Secondary immunodeficiencies, on the other hand, are not genetic and can be caused by factors like infection, malnutrition, or environmental exposures. Unlike primary immunodeficiencies, some secondary immunodeficiencies may be reversible if the underlying cause is addressed.