SAS 29

1. D

 Calcium glycerophosphate (Prelief) alkalinizes the urine and can help to

relieve the irritation from acidic foods. A diet low in acidic foods is
recommended and if a multivitamin is used, high-potency vitamins should be
avoided because these products may irritate the bladder. A
voiding diary is useful in diagnosis but does not need to be kept indefinitely.

2. A

Urine is cloudy in cystitis because of bacterial and white cells.

3. D

With nocturia the patient has to get up during the night to urinate. Limiting
fluids 2 hours before bedtime minimizes nocturia.

4. D

Kegel exercises strengthen pelvic floor muscles and are effective in urine
control in patients with urge incontinence and difficulty starting and stopping
urination.

5. B

The classic symptoms of cystitis are severe burning on urination, urgency,

and frequent urination. Systemic symptoms, such as fever and nausea and
vomiting, are more likely to accompany pyelonephritis than cystitis.
Hematuria may occur, but it is not as common as frequency and burning.

6. B

Intermittent pain that is less colicky indicates that the calculi may be moving
along the urinary tract. Fluids should be encouraged to promote movement,
and the urine should be strained to detect passage of the stone. Hematuria
is to be expected from the irritation of the stone. Analgesics should be
administered when the client needs them, not routinely. Moist heat to the
flank area is helpful when renal colic occurs, but it is less necessary as pain
is lessened.
7. C

A client scheduled for an IVP should be assessed for allergies to iodine and
shellfish. Clients with such allergies may be allergic to the IVP dye and be at
risk for an anaphylactic reaction. Adequate fluid intake is important after the
examination. Bladder spasms are not common during an IVP. Bowel
preparation is important before an IVP to allow visualization of the ureters
and bladder, but checking for allergies is most important.

8. B

After an IVP, the nurse should encourage fluids to decrease the risk of renal
complications caused by the contrast agent. There is no need to place the
client on bed rest or administer a laxative. An IVP would not cause
hematuria.

9. A

Because a high-purine diet contributes to the formation of uric acid, a low-

purine diet is advocated. An alkaline-ash diet is also advocated because uric
acid crystals are more likely to develop in acid urine. Foods that may be
eaten as desired in a low-purine diet include milk, all fruits, tomatoes,
cereals, and corn. Foods allowed on an alkaline-ash diet include milk, fruits
(except cranberries, plums, and prunes), and vegetables (especially legumes
and green vegetables). Gravy, chicken, and liver are high in purine.

10. B

Allopurinol (Zyloprim) is used to treat renal calculi composed of uric acid.

Adverse effects of allopurinol include drowsiness, maculopapular rash,
anemia, abdominal pain, nausea, vomiting, and bone marrow depression.
Clients should be instructed to report rashes and unusual bleeding or
bruising. Retinopathy, nasal congestion, and dizziness are not adverse
effects of allopurinol.