A patient asks the nurse for ways to prevent recurrent urinary tract infections.

1 -- An appropriate response to this patient is to avoid douching. Instruct women to cleanse the perineal area from front to back after voiding and defecating. Teach women to void before and after sexual intercourse to flush out bacteria introduced into the urethra and bladder. Teach measures to maintain integrity of perineal tissues such as avoiding bubble baths, feminine hygiene sprays and vaginal douches; wearing cotton briefs and avoiding synthetic materials such as nylon; if postmenopausal, using hormone replacement therapy or estrogen cream.