Which of the following should be included when developing a teaching plan to prevent urinary tract infection? Select all that apply.
A. Maintaining adequate fluid intake
B. Avoiding urination before and after intercourse
C. Emptying bladder with urination
D. Wearing underwear made of synthetic material such as nylon
E. Keeping urine alkaline by avoiding acidic beverages
F. Avoiding bubble baths and tight clothing
Correct Answer: A, C, & F
Even with proper antibiotic treatment, most UTI symptoms can last several days. In women with recurrent UTIs, the quality of life is poor. About 25% of women experience such recurrences. Many cases of uncomplicated UTIs will resolve spontaneously, without treatment, but many patients seek therapy for symptom relief.
Option A: Fluid intake helps dilute urine and minimize infection potential. Even without treatment, most UTIs will spontaneously resolve in about 20% of women; especially if increased hydration is used. The likelihood that a healthy female will develop acute pyelonephritis is very small.
Option B: Void before and after intercourse (if sexually active). Sexual intercourse is a common cause of a UTI as it promotes the migration of bacteria into the bladder. Although there is no proof of prevention, women should urinate after sexual intercourse because bacteria in the bladder can increase by ten-fold after intercourse.
Option C: Emptying the bladder fully with each urination prevents stasis. People who frequently void and empty the bladder tend to have a lower risk of a UTI. Frequent urination and high urinary volumes are also known to decrease the risk of UTI.
Option D: Children and teens should wear cotton underwear. The majority of organisms causing a UTI are enteric coliforms that typically inhabit the periurethral vaginal introitus. These organisms ascend the urethra into the bladder and cause UTI.
Option E: Keep the urine acidic. Urine is an ideal medium for bacterial growth. Factors that make it less favorable for bacterial growth include a pH less than 5, the presence of organic acids, and high levels of urea. Normal urine pH is slightly acidic, with usual values of 6.0 to 7.5, but the normal range is 4.5 to 8.0. A urine pH of 8.5 or 9.0 is often indicative of a urea-splitting organism, such as Proteus, Klebsiella, or Ureaplasma urealyticum.
Option F: Bubble baths and tight clothing may act as irritants. Vigorous urine flow is helpful to prevention. Baths should be avoided in favor of showers. A gentle, liquid soap should be used in bathing (such as Ivory or Dial) or a liquid baby soap such as Johnson’s baby shampoo which is very acceptable for the vagina.