A nurse manager at a skilled nursing facility has noticed an increase in urinary tract infections (UTIs) by 12% in the past year. In an e?ort to decrease this rate, which of the following should the nurse manager teach the nursing sta?? (Select all that apply.)

The correct answer is D. Urine output 75 mL in 1 hr.

Adequate urine output (at least 30 mL/hr) indicates effective hydration, showing that the kidneys are functioning properly and fluid balance is improving. A urine output of 75 mL in 1 hour suggests sufficient fluid replacement.

Here’s why the other options are incorrect:

• A. Urine specific gravity 1.005 to 1.030 – This range covers both normal and abnormal values. In dehydration, urine specific gravity is usually high (>1.030) due to concentrated urine. Effective treatment should lead to lower urine specific gravity, but the full range does not confirm improvement.

• B. Decreased pulse pressure – Pulse pressure is the difference between systolic and diastolic blood pressure. Dehydration typically causes a narrowed pulse pressure, so improvement should lead to a normal or increased pulse pressure rather than a decrease.

• C. Lightheadedness – Dizziness and lightheadedness are signs of dehydration-related hypotension. Effective hydration should resolve these symptoms, not maintain them.

Choice A reason: A raised red rash is not typically indicative of venous insufficiency but could suggest an allergic reaction or infection.

Choice B reason: Coldness and numbness distal to the fistula site can indicate poor blood flow, which is a symptom of venous insufficiency.

Choice C reason: Pain proximal to the fistula site can be a sign of venous hypertension and insufficiency, as it may

indicate increased pressure in the veins.

Choice D reason: Foul-smelling drainage is not a typical sign of venous insufficiency but may indicate an infection.