A nurse cares for a postmenopausal client who has had two episodes of bacterial urethritis in the last 6 months. The client asks, "I never have urinary tract infections. Why is this happening now?" How should the nurse respond?
a. "Your immune system becomes less effective as you age."
b. "Low estrogen levels can make the tissue more susceptible to infection."
c. "You should be more careful with your personal hygiene in this area."
d. "It is likely that you have an untreated sexually transmitted disease."
ANS: B
Low estrogen levels decrease moisture and secretions in the perineal area and cause other tissue changes, predisposing it to the development of infection. Urethritis is most common in postmenopausal women for this reason. Although immune function does decrease with aging and sexually transmitted diseases are a known cause of urethritis, the most likely reason in this client is low estrogen levels. Personal hygiene usually does not contribute to this disease process.
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