Between and Rock and a Hard Place

UTI's are the bane of my existence.

I know what we're supposed to do to prevent them. Toilet the resident's regularly, do proper perineal care, offer them a drink at every opportunity, yadda, yadda, yadda.

But what do you do when you have a resident on a fluid restriction? I know from personal experience that keeping yourself clean and voiding regularly don't work very well if you can't drink enough fluids to flush out your bladder. Granted, these folks are usually on a diuretic of some kind, but it still seems like we're constantly poking antibiotics down some of them. No sooner do we get one infection cleared up than we have another one in the works.

I realize that this could just be the result of their other diagnoses (immobility due to hip fracture, diabetes, bowel incontinence, Multiple Sclerosis and other neurological conditions), but it's still frustrating when you try to do everything right and the resident gets sick anyway.

I suppose it's up to the physician to determine the optimum fluid intake that will allow the resident to remain UTI free and also out of danger from CHF. Still, I'd like to have a meter that tells me that the resident is properly hydrated without the guess work. Maybe I'll invent one after I create that teleporter that allows me to just show up at work instead of having to drive there.