Practice Quiz

NCLEX-RN

Category - Basic Care

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While assessing a client with an indwelling urinary catheter, the nurse notes crystallization on the distal part of the catheter, just near the urine drainage bag. The nurse also notes slight bladder distention and low urine output during the end of shift report. Which of the following interventions is done next?
  1. Flush the Foley catheter with 10 ml normal saline solution.
  2. Change the urine drainage bag.
  3. Change the Foley catheter.
  4. Encourage the client to increase oral fluid intake.
Explanation
Answer: C - The preferable action of the nurse is to change the Foley catheter. Encrustation or crystallization results from alkalinization, which is due to bacterial invasion. Visible crystals and crusts in the external urinary catheter are highly suggestive of crystallization in the balloon and the catheter lining in the bladder. Failure to spot the problem, changing the catheter, or flushing the catheter with normal saline could result in ascending reflux of urine. The reflux can cause an infection in the kidneys or in the bloodstream. The most effective way to prevent crystallization and encrustation is to dilute the urine to maintain its acidity and wash off the bacterium in the lining.
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