The nurse is planning a teaching session for a patient on preventing urinary tract infections. Which of the following information should the nurse include in the teaching? Select all that apply.

Choice a reason: The patient uses clean technique when instilling the dialysate is incorrect and requires additional teaching. Peritoneal dialysis requires sterile technique to prevent infection. Using a clean technique, which is less rigorous than sterile technique, increases the risk of introducing pathogens into the peritoneal cavity. Proper sterile technique involves meticulous hand hygiene, using sterile gloves, and ensuring all equipment and supplies are sterile.
Choice b reason: The patient performs exchanges on a table with a sterile drape is appropriate. Using a sterile drape helps maintain a sterile field and reduces the risk of contamination during the dialysis procedure. This practice is an important part of sterile technique and helps ensure the patient's safety.
Choice c reason: The patient verbally expresses symptoms to report to the HCP is a positive behavior. Being aware of and communicating symptoms that may indicate complications, such as signs of infection or peritonitis, is crucial for timely intervention and management. This practice shows the patient is knowledgeable about monitoring their health and knowing when to seek professional help.
Choice d reason: The patient washes their hands before beginning is an essential step in both clean and sterile techniques. Proper hand hygiene is critical in preventing the spread of infection and is a fundamental practice in peritoneal dialysis. Washing hands thoroughly before starting the procedure helps minimize the risk of contamination.

Choice a reason: The patient who has an indwelling catheter for a urinary tract infection (UTI) is at the highest risk of developing urosepsis. Indwelling catheters provide a direct pathway for bacteria to enter the urinary tract, leading to infections that can escalate to sepsis. Monitoring this patient closely for signs of urosepsis, such as fever, chills, altered mental status, and increased heart rate, is crucial to ensure early detection and intervention.
Choice b reason: While the patient who is unable to obtain fluids independently is at risk for dehydration, which can lead to urinary tract infections, the immediate risk of urosepsis is lower compared to a patient with an indwelling catheter. Ensuring adequate fluid intake is important, but this condition does not present the same direct risk of bacterial entry into the urinary system as an indwelling catheter does.
Choice c reason: The patient who has undergone surgery for placement of an ileostomy does not have a direct connection to the urinary system that would increase the risk of urosepsis. While this patient might require monitoring for postoperative complications and hydration status, the focus is not specifically on urosepsis.
Choice d reason: The patient with continuous urinary incontinence is at risk for skin breakdown and potential urinary tract infections due to constant moisture and bacteria in contact with the skin. However, the risk of urosepsis is not as immediate or direct as it is with an indwelling catheter. Regular skin care and monitoring for signs of infection are necessary, but the focus on urosepsis is less urgent than for a patient with a catheter.