A nurse cares for a middle-aged female patient diagnosed with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year. The patient asks, "What can I do to help prevent these infections?" How would the nurse respond?

Choice A reason: Using tampons instead of sanitary napkins does not prevent urinary tract infections or pyelonephritis. In fact, improper tampon use may increase the risk of vaginal irritation or infection. Choice B reason: Increasing fluid intake and frequent bladder emptying helps flush bacteria from the urinary tract, reducing the risk of ascending infections like pyelonephritis. This is a key preventive strategy, especially in patients with diabetes who are more susceptible to infections. Choice C reason: While controlling blood glucose is important for overall health and immune function, aiming for an A1C under 9% is not optimal. The target should generally be below 7% for most adults. Moreover, glucose control alone does not directly prevent urinary tract infections. Choice D reason: Routine urine testing for ketones and proteins is not a standard preventive measure for pyelonephritis. These tests are more relevant in monitoring diabetic control and kidney function, not infection prevention.