A school nurse is conducting a health class for fifth-grade girls. The nurse instructs the girls that when toileting, they must remember to wipe from front to back. Which statement by a student indicates the need for further education?
1. "Girls need to wipe from front to back to avoid urinary tract infections."
2. "Girls must be careful about the way they wipe to prevent infection from bacteria present near the rectum."
3. "Girls must be careful how they wipe because the connection from the outside to the bladder is very short."
4. "Girls need to wipe front to back only after a bowel movement."
Correct Answer: 4
Rationale 1: This is a correct statement. Girls are more prone than boys to urinary tract infections. Wiping from front to back moves the bacteria away from the urethra.
Rationale 2: This is a correct statement. Girls need to avoid contaminating the urethral region with bacteria present in the rectal area.
Rationale 3: This is a correct statement. Girls have shorter urethras than boys, which allows easier access for the bacteria to move into the bladder.
Rationale 4: This is an incorrect statement. Girls should wipe front to back at all times because bacteria are present in the rectal area at all times.
Global Rationale: The male and female urinary tracts are identical, with the exception of the urethra, which is shorter in the female and located closer to the anus. This anatomic difference results in the periurethral region of the female being populated by bacteria that are normally restricted to the gastrointestinal (GI) tract, and could cause UTIs. These anatomic differences result in a higher risk of UTI in females.
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