Ted is a 76-year-old male who fell at home and sustained a fracture of his right hip. He is being admitted to your unit and will have surgery in the morning. Ted has a past medical history of urinary calculi, benign prostatic hypertrophy, and hypertension. When he arrived at the medical-surgical unit, he had a strong body odor and visible dirt on his body. An indwelling urinary catheter was placed in the ED.

Ted is at greatest risk for a UTI due to:

a) History of benign prostatic hypertrophy (BPH)
b) Poor hygiene
c) Indwelling urinary catheter
d) History of urinary calculi
e) His age

The correct option is c) Indwelling urinary catheter. The indwelling urinary catheter is the primary factor placing Ted at the highest risk for developing a UTI, despite other contributing factors related to his health history and hygiene.

Explanation:

Ted, a 76-year-old male, who recently sustained a hip fracture and has a past medical history of urinary calculi, benign prostatic hypertrophy, and hypertension, is at greatest risk for a urinary tract infection (UTI) primarily due to the indwelling urinary catheter that was placed in the Emergency Department (ED). The presence of an indwelling catheter is a well-known risk factor for developing UTIs, particularly in hospitalized or post-operative patients. While his age, history of benign prostatic hypertrophy (BPH), history of urinary calculi, and poor hygiene can all contribute to UTI risk, the catheter remains the key issue as it provides a direct route for bacteria to enter the urinary tract. This fact is supported by clinical evidence, suggesting that catheterized individuals are more susceptible to UTIs, as seen in the case vignettes provided.