A nurse is caring for a client diagnosed with urethritis. Which nursing intervention should be the priority?
1Encourage increased fluid intake to promote urinary tract flushing✓ 정답
2Apply a heating pad to the lower abdomen for comfort
3Restrict fluid intake to reduce urinary frequency
4Administer analgesics only when pain becomes severe
해설
Increased fluid intake is the priority intervention for urethritis as it helps flush bacteria from the urinary tract and dilutes urine, reducing irritation. Other options provide comfort but do not address the underlying pathophysiology.
Clinical Judgment
This question evaluates prioritization and the pathophysiological management principles of urethritis. The core is the main treatment goal for infectious urethritis, which is eliminating the pathogen from the urinary tract. Notify HCP! While antibiotic prescription is the fundamental treatment, increased fluid intake, both before and after antibiotics take effect, is an immediate and essential adjunctive therapy that physically flushes out pathogens and dilutes urine to reduce pain. Other interventions focus on symptom relief but do not directly contribute to resolving the underlying problem (infection).
Memory Tip: The core of urethritis management is "Flush it out!" The top priority is to Flush the infection out with Fluids.
KR vs US: In Korea, there is a tendency to emphasize 'drinking plenty of warm water' for patients with urethritis. In the US NGN, this is clearly presented from the perspective of Evidence-Based Practice as a core nursing intervention, based on research evidence that increased fluid intake is effective in preventing and managing urinary tract infections. However, cases requiring fluid restriction, such as heart failure or kidney disease, are exceptions.
Clinical Practice Guide
When managing patients with urethritis:
1. Education: Encourage fluid intake of 2-3L per day, especially water. Cranberry juice may support urinary tract health.
2. Medication: Educate the patient to complete the full course of prescribed antibiotics, and optimize pain control by administering analgesics regularly as needed.
3. Hygiene: Teach proper perineal hygiene (such as wiping from front to back) and urination after sexual intercourse.
Caution: In SATA (Select All That Apply) questions, "fluid restriction" (option 3) is an absolute contraindication for patients with urinary tract infections. This is a common distractor. Also, "administer analgesics only when pain worsens" (option 4) contradicts effective pain management principles; preventive or scheduled dosing leads to better outcomes.
Urethritis — Inflammation of the urethra. It is mainly caused by bacterial (e.g., chlamydia, gonorrhea) or viral infections, or chemical irritation.
Urinary Tract Flushing — A process that mechanically flushes bacteria and debris from the urinary tract through increased fluid intake and urination. It is a core concept in the prevention and management of urinary tract infections.
Dysuria — Pain or burning sensation during urination. This is a typical symptom of urethritis.
Antibiotic Therapy — Use of antibiotics to treat bacterial infections. As a fundamental treatment for urethritis, identifying the causative pathogen is important for selecting the appropriate antibiotic.
Fluid Intake Recommendation — For urinary tract health, it is generally recommended to drink 2-3 liters of fluids per day. This applies if there are no issues with kidney or heart function.