A nurse in a community clinic is assessing an older adult client for manifestations of dehydration. Which of the following findings should the nurse expect?

A. Diuretic use: Some diuretics, particularly thiazides, are actually prescribed to prevent calcium stone formation by reducing urinary calcium excretion. Diuretic use is not considered a primary risk factor for urolithiasis.

B. BMI less than 25: A lower BMI is not linked with kidney stone formation. In fact, higher BMI and obesity are more commonly associated with an increased risk due to metabolic changes that affect urine composition.

C. Family history: A positive family history significantly increases the risk of developing urolithiasis. Genetic predisposition and shared environmental factors contribute to stone formation, making this a strong and well-established risk factor.

D. Hypocalcemia: Urolithiasis is often associated with hypercalcemia or hypercalciuria, which increase the concentration of calcium in urine and promote stone development. Hypocalcemia does not contribute to stone formation and is not a risk factor.

• Monitoring vital signs is important to detect changes such as fever or hemodynamic instability, but it is not a primary infection control measure. Vital signs reflect the presence of infection rather than actively preventing contamination during peritoneal dialysis.

• Checking blood glucose levels is essential for diabetic clients, since hyperglycemia can worsen infection risk and healing capacity. However, glucose monitoring is not a direct infection control practice related to preventing peritoneal dialysis–associated peritonitis.

• Performing hand hygiene is a critical infection control step because it minimizes the transmission of microorganisms from healthcare providers or caregivers to the peritoneal catheter site. Consistent hand hygiene reduces the risk of peritoneal contamination during exchanges.

• Applying antibiotic ointment at the catheter exit site reduces the chance of bacterial colonization and local infection. Preventing exit-site infections is crucial, since they can progress to tunnel infections or peritonitis if not controlled early.

• Assessing fluid intake helps evaluate fluid balance and kidney function, but it does not contribute to infection prevention. While important for overall care in dialysis clients, it is not an essential infection control practice.

• Using sterile techniques during catheter handling and dialysate exchanges prevents the introduction of microorganisms into the peritoneal cavity. Maintaining strict sterility is the cornerstone of preventing peritonitis in peritoneal dialysis patients.