A nurse is providing discharge teaching for a client who has hyperosmolar hyperglycemic syndrome (HHS). Which of the following topics should be prioritized for teaching?

A. Malignant brain tumors often originate from another part of the body: While malignant brain tumors can spread from other body parts (metastatic tumors), primary brain tumors, such as gliomas or meningiomas, originate in the brain itself. Malignant brain tumors that metastasize to the brain are relatively less common.
B. Primary CNS tumors commonly spread to other parts of the body: Primary central nervous system (CNS) tumors generally do not spread to other parts of the body. Most CNS tumors are localized, and their spread is usually restricted to the surrounding neural tissue, not to distant organs.
C. Most CNS tumors are spinal tumors: Most central nervous system (CNS) tumors are actually brain tumors, not spinal tumors. Brain tumors are more common in adults, while spinal tumors are rarer in comparison.
D. Ependymomas are primarily brain tumors: Ependymomas are a type of tumor that originates from the ependymal cells in the central nervous system. While they can occur in both the brain and spinal cord, they are more frequently found in the brain, especially in the ventricles. Thus, ependymomas are primarily considered brain tumors.

A. "As a female, you have a shorter urethra creating an easier way for bacteria to invade your bladder."
The female urethra is approximately 3-4 cm long, which allows bacteria from the perineal area, particularly E. coli, to reach the bladder more easily, making UTIs more common in females. This anatomical factor is a well-established and evidence-based reason for increased UTI susceptibility in women.
B. "If you take too many showers you are more susceptible to getting a UTI because you are washing off the protective bacteria." Frequent showers do not significantly disrupt the natural flora in a way that predisposes to UTIs. In fact, it is poor perineal hygiene or use of irritants like douches or perfumed soaps that may increase the risk, not simply the act of showering often.
C. "As a female, you have more E. coli in your gastrointestinal system that can enter the bladder through your urethra." Both males and females have similar levels of E. coli in the gastrointestinal tract; the difference lies in the anatomical proximity of the anus to the urethra in females, not the quantity of E. coli. The statement misrepresents the actual cause of increased risk in women.
D. "At your age, you have more sexual intercourse than older females making you more likely to get a UTI." While sexual activity is a risk factor for UTIs, this statement makes a generalized assumption about sexual behavior based on age and lacks sensitivity. It is also less accurate than the anatomical explanation provided in option A.