A nurse is caring for a client in the medical-surgical unit.

Exhibits

Which of the following actions should the nurse take to decrease the risks for urinary tract infection for this client? Select all that apply.

Rationale
A.    Review the need for the indwelling urinary catheter daily.
One of the most effective strategies to prevent UTIs is avoiding unnecessary catheterization. The nurse should regularly assess whether the catheter is still necessary and remove it as soon as possible. Keeping a catheter in place longer than needed increases the risk of infection.
B.    Encourage the client to drink 3000 mL of fluid daily.
Increasing fluid intake is generally a good measure to help flush the urinary tract, reducing the concentration of bacteria and preventing infections. However, for clients with heart failure, excessive fluid intake can exacerbate fluid overload, leading to pulmonary edema and worsened symptoms of heart failure. Therefore, the nurse should consult the healthcare provider before recommending a specific amount of fluid intake (such as 3000 mL). The nurse should ensure that the client’s fluid intake is balanced with their heart failure management plan.
C.    Place the drainage bag on the bed when transporting the client.
The drainage bag should always be kept below the level of the bladder to prevent urine from flowing back into the bladder, which can lead to infections. Placing the drainage bag on the bed when transporting the client would increase the risk of urine reflux, potentially leading to a UTI. The bag should be secured properly and kept off the bed or floor during transport.
D.    Empty the drainage bag when it is half-full.
The drainage bag should be emptied when it is full (typically around 2/3 to 3/4 full) to prevent overfilling, which can increase the risk of backflow or spillage. Emptying the bag when it is half-full may lead to unnecessary handling of the catheter and increases the risk of contamination. It’s important to empty the bag regularly, but not excessively often.
E.    Change the indwelling urinary catheter tubing every 3 days.
There is no need to change the indwelling catheter tubing on a regular basis unless there is a specific indication (e.g., blockage or infection). Frequent changes of the catheter tubing increase the risk of introducing bacteria. According to best practice guidelines, the catheter should be changed only when necessary, not routinely every 3 days.
F.    Use soap and water to provide perineal care.
Regular and gentle perineal care with soap and water is crucial for reducing the risk of UTIs. The perineal area should be cleaned daily and after any incontinence episodes to minimize bacterial contamination of the catheter and urinary tract. It’s important to avoid harsh chemicals, which could irritate the skin and urinary tract.