A sexually active female client has had 3 urinary tract infections (UTIs) in 12 months. Which instructions should the nurse include in teaching the client how to prevent UTI recurrence? Select all that apply.

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The nurse should encourage a sexually active female client to implement the following interventions to help prevent recurrent UTIs: Take all antibiotics as prescribed even if symptoms have improved as bacteria may still be presentIncrease fluid intake; this dilutes the urine (minimizing bladder irritation), promotes frequent urination, and prevents urinary stasis. The client should void at least every 2-4 hours. Some health care providers recommend drinking cranberry juice as it inhibits bacterial attachment to the bladder wall, but there is no clinical evidence to support its effectiveness in preventing UTIs (Option B).Wipe from front to back to prevent introducing bacteria from the vagina and anus into the urethraAvoid synthetic fabrics as these materials (eg, nylon, spandex) seal in moisture and create an environment conducive to bacterial proliferation; cotton underwear is recommended instead (Option F).Void after sexual intercourse to flush out bacteria that may have entered the urethra (Option E). Take all antibiotics as prescribed even if symptoms have improved as bacteria may still be present Increase fluid intake; this dilutes the urine (minimizing bladder irritation), promotes frequent urination, and prevents urinary stasis. The client should void at least every 2-4 hours. Some health care providers recommend drinking cranberry juice as it inhibits bacterial attachment to the bladder wall, but there is no clinical evidence to support its effectiveness in preventing UTIs (Option B). Wipe from front to back to prevent introducing bacteria from the vagina and anus into the urethra Avoid synthetic fabrics as these materials (eg, nylon, spandex) seal in moisture and create an environment conducive to bacterial proliferation; cotton underwear is recommended instead (Option F). Void after sexual intercourse to flush out bacteria that may have entered the urethra (Option E). (Options A and D) Avoid douching and using feminine perineal products (eg, deodorants, powders, sprays), as they can alter the vaginal pH and normal flora, increasing the risk for infection. Take showers instead of baths as bath products (eg, bubble bath, oils) and bacteria in bath water can irritate the urethra and increase the risk of infection. (Option C) Avoid spermicidal contraceptive jelly as it can suppress the production of protective vaginal flora. Discontinue diaphragm use temporarily (until symptoms subside and antibiotic course is completed); a diaphragm increases pressure on the urethra and bladder neck, which may inhibit complete bladder emptying. Educational objective: Interventions to help prevent recurrent UTIs in sexually active female clients include avoiding use of feminine perineal products, vaginal douches, and spermicidal contraceptive jelly. Protective factors include wearing cotton underwear, increasing water intake, and voiding immediately after sexual intercourse.

A Sexually Active Female Client Has Had 3 Urinary Tract