If an indwelling catheter is necessary, the following specific nursing interventions are initiated to prevent CAUTI (Select all that apply)

Catheter-associated urinary tract infections involve biofilm formation and migration of uropathogens through the periurethral space. Prevention focuses on minimizing colonization by reducing duration, maintaining structural integrity of the drainage system, and utilizing meticulous sterile technique to prevent the introduction of microbes into the sterile bladder environment. A. Using 70% ethyl alcohol for perineal care is contraindicated as it causes significant mucosal irritation and disrupts the natural protective flora of the urogenital tract. Standard practice involves daily cleansing with soap and water or specialized perineal cleansers. Alcohol can cause tissue breakdown, actually increasing the risk of infection. B. The duration of catheterization is the single most important risk factor for developing a CAUTI. Nurses must advocate for the earliest possible removal of the device to prevent the formation of bacterial biofilms. Every day the catheter remains in place increases the cumulative risk of bacterial entry into the bladder. C. While monitoring urine characteristics is a standard nursing assessment for detecting potential infection or dehydration, it is not a direct intervention that prevents the occurrence of CAUTI. Inspection helps in early identification of complications like hematuria or pyuria but does not mechanically or biologically block the infectious process itself. D. Strict aseptic technique is vital during insertion to prevent the introduction of exogenous bacteria. Using the smallest diameter catheter possible minimizes urethral trauma and irritation. Mechanical injury to the urethral mucosa creates a portal of entry for pathogens, so reducing the catheter size helps maintain tissue integrity. E. Maintaining a closed drainage system is a primary defense mechanism against the entry of microorganisms. Breaking the seal between the catheter and the drainage bag allows pathogens to enter the lumen and migrate to the bladder. Ensuring the system remains uninterrupted prevents the intraluminal route of bacterial transmission. F. Obtaining urine specimens through the designated sampling port using aseptic technique preserves the closed system. Following manufacturer instructions ensures that the needleless access site is properly disinfected and sealed. This prevents the nurse from needing to disconnect the catheter from the tubing, which would expose the system. G. Securing the catheter is a correct intervention, but it must be secured to the patient's thigh or abdomen, never the bed frame. Securing it to the bed frame increases the risk of accidental tension and mucosal trauma if the patient moves. Movement of the bed frame can pull the device.