NCM 106: PHARMACOLOGY s

Chapter 1

LEARNING ACTIVITY 1: ESSAY

1. A 58-year-old patient with Parkinson’s disease is placed on levodopa (Larodopa). In obtaining her health
history, the nurse notes that the patient takes Mylanta on a regular basis for mild indigestion and also 8takes
multivitamins daily (vitamins A, B6, D, and E). What should the nurse include in teaching for this patient?
 The nurse should advise the patient to talk to their doctor about whether or not they need to take
Mylanta daily. Because this antacid contains magnesium, it may increase levodopa absorption and
toxicity. Since vitamin B6 may interact negatively with the drug, the patient should be taught to limit
meals containing it (such as bananas, wheat germ, and green vegetables).

2. A patient is on levodopa and benztropine (Cogentin). During a regular office follow-up, the patient tells the
nurse that she is going to Arizona in July to visit her grandchildren. What teaching is important for this patient?
 The ability of a patient on benztropine (Cogentin) to endure heat is reduced. Since benztropine reduces
sweating, you may be more susceptible to heat stroke. Because Arizona in July is hot, the patient should
be advised to avoid being overheated, increase rest periods, prevent exertion, and watch for indicators of
heat intolerance. When symptoms appear, the patient should see a doctor. In the event that the patient is
unable to communicate for herself, the nurse should urge her to receive medical identification jewelry.

3. A 67-year-old patient with Alzheimer’s disease is on donepezil (Aricept) and has a history of congestive
heart failure, type 2 diabetes mellitus, and hypertension. The patient’s wife asks the nurse if this new medicine
is appropriate for her husband to take. How should the nurse respond? What teaching should
be provided?
 Since the scope of the routine of nursing practice does not include the profound knowledge on the
appropriateness of medication, the nurse should refer the patient and his wife to a health care provider
who is a specialist in that matter. The couple should be informed about potential side effects of this
medicine, including postural hypotension and bradycardia, especially if the patient is already taking
cardiac medications that may affect blood pressure or heart rate. Anorexia is another potential issue.
Since the patient has diabetes, he requires a balanced diet to avoid hypoglycemia. During early therapy,
the patient should monitor his blood glucose more frequently until the drug's effects on appetite are
known.

4. A 46-year-old male quadriplegic patient has been experiencing severe spasticity in the lower extremities,
making it difficult for him to maintain his position in his electric wheelchair. Prior to the episodes of spasticity,
the patient was able to maintain a sitting posture. The risks and benefits of therapy with dantrolene (Dantrium)
have been explained to him, and he has decided that the benefits outweigh the risks. What assessments should
the nurse make to determine whether the treatment is beneficial?

 After one week of therapy, the nurse would anticipate a decrease in the spasticity of the patient. The
medication regimen is usually discontinued if there has been no improvement after 45 days. The nurse
 should measure the patient's muscular stiffness, pain experience, range of motion, and ability to maintain
posture and alignment while in a wheelchair to determine if spasticity has decreased. Dantrolene should
not be taken when spasticity is required to maintain posture. In this case, the patient's spasticity was new
and was the cause of his inability to maintain posture, something he had previously been able to do.

LEARNING ACTIVITY 2: CROSSWORD PUZZLE

1. Acetylcholine

2. Neostigmine

3. Cholinergic crisis

4. Myasthenic crisis

5. Edrophonium

6. Myelin sheath

7. Dantrium

8. Hemiplegia

9. Ptosis

10. Fasciculation

Chapter 2
LEARNING ACTIVITY 1: CASE STUDY
ST, a 64-year-old patient, has heart failure (HF), which is being controlled with digoxin (Lanoxin),
furosemide (Lasix), and a low-sodium diet. She is taking potassium chloride (KCl) 20 mEq per day orally.
Three days ago, ST had flulike symptoms such as anorexia, lethargy, and diarrhea. Her fluid and food intake
was diminished. She refused to take the KCl and stated that the drug makes her sick. She has been taking the
digoxin and furosemide daily. The nurse’s assessment during the home visit includes poor skin turgor, poor
muscle tone, irregular pulse rate, and decreased bowel sounds. The nurse obtained a blood sample for serum
electrolytes; results indicated potassium (K) 2.9 mEq/L, sodium (Na) 137 mEq/L, and chloride (Cl) 96 mEq/L.
1. List reference values for serum potassium (K), serum sodium (Na), and serum chloride (Cl). Are ST’s
electrolyte levels within normal range? Explain your answer.
 Serum potassium (K) should be between 3.5 and 5.5 mEq/L, sodium (Na) should be between 135 and
145 mEq/L, and serum chloride should be between 96 and 106 mEq/L. ST's serum sodium and chloride
levels are within normal ranges, despite her chloride being on the border line, according to the statistics
supplied. Her potassium level is also 2.9 mEq, which implies "hypokalemia or potassium deficiency"
because her serum potassium level is less than 3.5 mEq/L. Excessive loss, rather than a lack of intake, is
the most common cause of hypokalemia. This may be seen in ST's case, where her potassium deficiency
is caused by a variety of factors or activities.

2. Match ST’s physical findings with the corresponding electrolyte imbalance.

 Low serum K S&Sx:
-Weakness and Fatigue.
-Muscle Cramps and Spasms.
-Digestive Problems.
-Heart Palpitations.
-Muscle Aches and Stiffness.
-Tingling and Numbness.
-Breathing Difficulties.
-Mood Changes.

3. What are the reasons for the electrolyte imbalance?

 ST's electrolyte imbalance arises from her anorexia, which resulted in her not meeting her daily dietary
requirements due to a lack of appetite. Taking a daily dose of furosemide, a potassium-depleting
supplement, while refusing to take potassium chloride, which would replenish her body with potassium.
As a result, hypokalemia or a potassium deficiency develops.

4. ST said she was not taking KCl because the drug makes her sick. What information can you give her
concerning the administration of potassium?
 Explain that this medication was prescribed to alleviate potassium depletion caused by the use of
furosemides. Potassium side effects such as nausea, vomiting, abdominal pain, and diarrhea should be
addressed. To avoid GI upset, take with a full glass of water and food at all times. Medicine compliance
is important, especially for Kcl, because one of the side effects of ST's furosemide is potassium loss. If
nausea, vomiting, diarrhea, or stomach pains persist, contact your doctor. It's possible that the dosage
 can be changed. Emphasize the need of having regular follow-up exams to track serum levels and
development.

5. What is the effect of furosemide on digoxin when there is a potassium deficit? Explain your answer.
 In hypokalemic patients, digitalis chemicals are prohibited. Due to the renals' ability to eliminate
digoxin, impaired renal function results in higher digoxin plasma levels. Although furosemide and
digoxin are routinely used together, your potassium levels, as well as those of digoxin and magnesium,
may require more frequent monitoring. When there is a potassium deficit, the effect of furosemide on
digoxin intensifies, causing digoxin to have a stronger effect. This is because furosemide diminishes
potassium and causes hypokalemia, which amplifies the impact of digoxin. Cardiac dysrhythmias, which
ST exhibited, are a symptom of increasing digoxin impact.

6. Why should the nurse assess ST for digitalis toxicity? List the signs and symptoms of digitalis toxicity.
ST was referred to the health care provider because of her serum potassium deficit and its effect on digoxin. A
repeat serum potassium determination was taken, and the result was 2.8 mEq/L.A liter of 5% dextrose in water
with KCl 40 mEq/L was administered over 4 hours.
 ST should be assessed for digitalis toxicity, which is induced by a digoxin overdose. This is because it is
possible that it will occur in patients taking furosemide and digoxin, because furosemide tends to
increase the effect of digoxin; and it is more common in older adults, such as ST, who is displaying a
few of the symptoms of digitalis toxicity, such as anorexia, irregular pulse rate, nausea, and diarrhea. As
a result, "confusion, anorexia, delirium, cardiac dysrhythmias, premature ventricular contractions,
bradycardia, green yellow halos, impaired vision, diarrhea, nausea, and vomiting" are signs and
symptoms of digitalis intoxication.

7. How many milliequivalents of KCl per hour would ST receive? Does this amount constitute an acceptable
dosage?
 A total of 40 mEq/L of KCl was given over the course of four hours. ST received 10 mEq per hour as a
result. Potassium can be provided at a rate of not more than 10 mEq/hour in a concentration of up to 40
mEq/L if the serum potassium level is greater than 2.5 mEq/L. ST is receiving 10 mEq each hour, which
is a reasonable amount.

8. Why is it important that the nurse monitor the rate of intravenous fluids containing potassium, the hourly
urine output, and vital signs?
 When a patient becomes dehydrated, vital indicators such as pulse rate, blood pressure, and respiration
rate fluctuate. The monitoring of vital signs is utilized to determine resuscitation and modify for
demands. It is critical to keep track of the rate of potassium-containing IV fluid administration to ensure
that it does not exceed 0.25 mEq/kg/hour based on a patient weight recorded within the previous 48
hours. Symptomatic hypokalemia may necessitate doses as high as 0.5 mEq/kg/hour. For patients
undergoing intravenous KCl infusions, electrocardiographic (ECG) monitoring is required. Rapid
infusions of KCl can cause arrhythmias, heart block, and cardiac arrest. It is also necessary to monitor
patient’s hourly urine output to ensure that they don't excrete the fluids any more rapidly, because they're
excreted very rapidly anyway.
9. Because of the low serum potassium level, what other electrolyte value should be checked? Explain your
answer. After ST’s serum electrolytes returned to normal, the health care provider instructed her to continue
taking the prescribed KCl dosage daily with her other medications.
 She should check other electrolyte value such as sodium, calcium, chloride, magnesium, and phosphate
as well as they could help in determining other problems in her body and tailor specific needs. She
should take her medications as instructed by her physician for faster recovery.

10. ST asks why she has to continue taking these drugs. What is the nurse’s best response?
 The nurse should explain to her the importance of taking the medication and how it will help her with
her condition. In ST’s case, she needs to continue taking KCl or potassium chloride as it will help
prevent or treat low blood levels of potassium (hypokalemia). Potassium is a mineral that your body
need for optimal heart, muscle, kidney, neuron, and digestive system functioning. If she does not take er
medication as instructed by the physician, it might lower her potassium level and can make muscles feel
weak, cramp, twitch, or even become paralyzed, and abnormal heart rhythms may develop.

11. The nurse instructs ST to eat foods rich in potassium. Which foods are the richest sources of potassium?
 Fresh and dried fruits, fruit juices and vegetables, and potatoes are among the potassium-rich foods that
the nurse should recommend to ST. Potassium-rich foods such seasoned spinach, cooked broccoli,
chestnuts, peas, and cumber should also be included in her diet.

Chapter 3
LEARNING ACTIVITY 1: CASE STUDY
MA, a 55-year-old patient, was recently diagnosed with bronchial asthma. Her mother and three brothers
also have asthma. In the past year, MA has had three asthmatic attacks that were treated with prednisone and
albuterol (Proventil) inhaler. At an office visit today, prednisone is prescribed for 4 weeks, and the order is
written as follows: day 1—1 tablet 4 times a day; day 2—1 tablet 3 times a day; day 3—1 tablet 2 times a day;
day 4—1 tablet in the morning; day 5—onehalf tablet in the morning.
1. Explain the purpose for the use of prednisone during an asthmatic attack. Explain why the dosage is
decreased (tapered) over a period of 5 days.
 Prednisone helps people with asthma reduce inflammation in their airways by acting on their immune
system. Prednisone is a hormone produced by the adrenal glands that is similar to cortisol. Adrenal
glands reduce cortisol production when taking prednisone for longer than a few weeks. Prednisone must
be administered for several days after your asthma symptoms have subsided in order to prevent the
swelling from returning, it is then gradually reduced to allow the adrenal glands to return to normal
function.

2. Can cromolyn sodium (NasalCrom) be substituted for prednisone during an asthmatic attack? Explain your
answer.
 Prednisone is normally only given during acute flare-ups and not to be taken for a long time. Cromolyn
sodium, on the other hand, is used as a preventative medication for bronchial asthma and must be taken
on a regular basis. Hence , cromolyn sodium cannot be used in place of prednisone during an asthma
attack.

3. MA is prescribed albuterol (Proventil, Ventolin). What effect does albuterol have on controlling asthma?
 Albuterol is a beta2 agonist that is selective. Since it is fast-acting and promotes bronchodilation, it can
be administered on an as-needed basis during an asthma attack.

4. For each drug dose, MA is to take two puffs of albuterol administered by the inhaler. What instructions
should she be given concerning use of the inhaler? To minimize the frequency of MA’s asthmatic attacks, the
health care provider prescribes theophylline (Elixophyllin) 200 mg twice a day. The albuterol inhalation is to be
taken as needed. Nursing interventions include patient history of asthmatic attacks and physical assessment.
 The proper use of an inhaler should be taught to the patient. Because albuterol and bronchodilators
expand the bronchioles, they should be used before other inhalers. When pressing down on the drug
canister, the patient should be instructed to take a calm, deep breath and hold it for as long as is
comfortable.

5. When taking the patient’s history, what should the nurse include concerning asthmatic attacks? What physical
assessment would suggest an asthmatic attack?
 The patient's exacerbation history is crucial in determining the following:
-Typical prodromal signs or symptoms, as well as exacerbation triggers
-Rapidity of onset
-Associated illnesses
-Number in the last year

6. What type of drug is Elixophyllin? Why should the nurse ask MA if she smokes?
  Elixophyllin, commonly known as theophylline anhydrous liquid, is a medication in the
Phosphodiesterase Enzyme Inhibitors, Nonselective, Xanthine Derivatives class. It is a methylxanthine
that is used to treat the symptoms and reversible airflow restriction caused by persistent asthma and
other chronic lung illnesses. It works by relaxing the muscles surrounding the airways, allowing them to
open up and allow you to breathe more easily. It also reduces the lungs' response to irritants. The nurse
should inquire about MA's smoking habits because smoking alters the way your body processes
theophylline, which may necessitate a greater dosage of the prescription, raising the potential of drug
toxicity.

7. What are the side effects, adverse reactions, and drug interactions related to Elixophyllin?
 When peak serum theophylline concentrations are 20 mcg/mL, adverse reactions and side effects
associated with Elicophyllin or theophylline are generally minor and primarily consist of brief caffeine-
like side effects such as nausea, vomiting, headache, and insomnia. When peak serum theophylline
concentrations exceed 20 mcg/mL, theophylline causes a variety of adverse responses, including chronic
vomiting, cardiac arrhythmias, and intractable seizures, all of which can be fatal. Theophylline interacts
with a wide range of medications. The interaction could be pharmacodynamic, which means that there
are changes in the therapeutic response to theophylline or another medicine. However, more often than
not, the interaction is pharmacokinetic, meaning that another drug alters the rate of theophylline
clearance, resulting in increased or decreased serum theophylline concentrations.

8. What nonpharmacologic measures can the nurse suggest that may decrease the frequency of asthmatic
attacks?
 Regular exercise, quitting smoking, learning breathing exercises, identifying triggers, and avoiding
stress can all help to prevent acute asthma attacks. Avoiding allergies, maintaining a healthy weight, and
using complementary treatments are all good ideas.

9. Which are appropriate rescue medications used for acute asthmatic attacks? Which drugs are used as
preventive medications?
 In acute asthmatic attacks, EpiPen (Epinephrine) and bronchodilators such as albuterol are utilized.
Leukotriene modifiers, such as montelukast, zafirlukast, and cromolyn, are used as prophylactic
medications.

Chapter 4
LEARNING ACTIVITY 1: CASE STUDY
CS, a 34-year-old woman, has been vomiting for 48 hours. In the last 12 hours, CS has had vomiting and
diarrhea. Prochlorperazine (Compazine) 10 mg was administered intramuscularly.
1. What nonpharmacologic measures should the nurse suggest when vomiting occurs?
 Nonpharmacologic interventions when vomiting occurs:
-Avoid any physical exertion.
-Avoid alcoholic and acidic beverages.
-Deep breathing techniques should be practiced.
-Encourage the consumption of soft, readily digestible food.
-Maintain hydration and instruct her to rinse her mouth after eating.
2. Why was CS given prochlorperazine intramuscularly and not orally or rectally? Prochlorperazine should be
given deep intramuscularly. Why?
 Since CS is experiencing diarrhea and vomiting, she is given prochlorperazine intramuscularly instead
of orally or rectally administering the medication. It may not be effective if administered orally or
rectally since she might end up vomiting or pooping the medication. To avoid local irritation,
prochorperazine should be administered intravenously.
3. What electrolyte imbalances may occur as a result of vomiting and diarrhea? Explain how they can be
replaced.
 Excessive vomiting, especially over a lengthy period of time, causes the body to lose a lot of water and
electrolytes. The majority of sodium and potassium are lost, along with other electrolytes. If she can
handle oral fluids, she should be encouraged to drink them, especially ORS, clear fluids, and juices,
while avoiding caffeine. If the client is unable to accept oral fluids, 0.9% normal saline can be
administered intravenously.
4. What are the side effects of prochlorperazine? Could these occur to CS? Explain your answer.
 The side effects include dizziness, drowsiness, anxiety, restlessness, dry mouth, constipation, weight
gain, headache and hypotension. I believe that the possibility of the patient experiencing these side
effects is little since she is not taking multiple drugs at ones and the dose is not very high. However,
factors like genetic and age might increase the possibility of the occurrence of these side effects.
5. Could a serotonin antagonist be given to CS instead of prochlorperazine? Explain your answer. CS was
prescribed diphenoxylate with atropine (Lomotil) 2.5 mg t.i.d.
 Because she is experiencing diarrhea and vomiting, prochlorperazine is a better choice than a serotonin
antagonist because it is primarily suggested as an antidepressant medicine but is more generally used to
treat other diseases such as anxiety and insomnia.
6. Is the diphenoxylate with atropine (Lomotil) dosage for CS within the normal prescribed range? Explain your
answer.
 The initial adult dosage for Lomotil is two tablets, taken four times a day. Since the drug order give to
CS is only 2.5 mg, which is equivalent to one tablet, three time a day, this indicates that the dosage given
to her is inadequate.

7. What clinical conditions are contraindicated for the use of Lomotil?

  Because there is an electrolyte imbalance, Lomotil should be administered. Otherwise, decreased
peristalsis in the stomach causes fluid retention, exacerbates dehydration, and causes electrolyte
imbalance. Lomotil should be taken with caution in patients who have a CNS illness, liver difficulties, or
gastrointestinal problems.
8. What are some combination drugs that may be prescribed to control diarrhea? Give their advantages and
disadvantages.
 Loperamide & Bismuth subsalicylate
 Loperamide:
 Advantages: It works by slowing the movement of the intestines. This reduces the number of
bowel movements while also making the feces less runny. It is also used to minimize the volume
of discharge in patients who have had ileostomy surgery. It is also used to treat chronic diarrhea
in persons suffering from inflammatory bowel disease. Loperamide simply cures the symptoms
of diarrhea, not the underlying cause.
 Disadvantages: it can cause Dizziness, drowsiness, tiredness, or constipation may occur
 Bismuth subsalicylate
 Advantage: It is used to alleviate occasional stomach distress, heartburn, and nausea. It is also
used to treat and prevent travelers' diarrhea.
 Disadvantage: it can cause constipation, dark colored feces, change the color of the tongue to a
dark tone
9. Explain the similarities of two over-the-counter antidiarrheals. Explain how frequently they should be
administered.
 Over-the-counter antidiarrheal drugs like Lomotil and Imodium are medicines used to treat both acute
and chronic diarrhea. These drugs operate in similar ways, which is to reduce the frequency and number
of bowel motions. Lomotil and Imodium are intended to be used for short-term diarrhea that normally
disappears within a few days of starting the medicine.
10. Do you think CS should receive an adsorbent? Explain your answer.
 Because CS is experiencing severe diarrhea and vomiting, she should be given an absorbent to assist and
make her diarrhea stools less watery.
11. Explain the similarities and differences between ipecac and charcoal.
 Activated charcoal absorbs a wide range of chemicals in the GI tract. It also has a limited potential to
attract certain poisons out of circulation and back into the gut, where they bind with it before being
expelled. Ipecac syrup, on the other hand, should not be administered in patients who have consumed
certain corrosive substances or who are fast losing consciousness, as this raises issues regarding airway
protection. Ipecac syrup, which is only effective for one hour after toxin absorption, just delays activated
charcoal administration.
Chapter 5
LEARNING ACTIVITY 1: CASE STUDY
JQ, a 58-year-old patient, has been recently diagnosed with hypertension. His resting blood
pressure is 158/92. He is prescribed hydrochlorothiazide 50 mg/day and told to eat foods rich in
potassium.
1. How does hydrochlorothiazide differ from furosemide (Lasix)? What are their similarities and
differences?
 Hydrochlorothiazide enhanced sodium and chloride fractional excretion more than furosemide
in hypertensive patients with severe renal failure. Lasix and hydrochlorothiazide are two other
medications used to treat hypertension. Because corticosteroid medications are used to treat
oedema, hydrochlorothiazide is also utilized. It is also used to treat calcium-containing kidney
stones.
2. Why is it necessary for JQ to eat foods rich in potassium when taking hydrochlorothiazide? Explain
your answer.
 Hydrochlorothiazide belongs to a class of drugs known as diuretics or"water pills." It works by
causing you to make more urine which leads to reduction of potassium concentration. When
using hydrochlorothiazide, one may need to take potassium supplements, limit salt intake, and
eat a potassium-rich diet that includes foods like bananas.
3. What are the nursing interventions that should be considered while JQ takes hydrochlorothiazide?
After 1 month on hydrochlorothiazide therapy, JQ becomes weak and complains of nausea and
vomiting. His muscles are “soft.” His serum potassium level is 3.3 mEq/L. JQ’s diuretic is changed to
triamterene/hydrochlorothiazide (Dyazide). Again, he is advised to eat foods rich in potassium.
 Exercise with caution during aerobic workouts, especially in hot weather. Sweating causes fluid
and electrolyte loss and may increase diuretic side effects (dizziness, muscle cramps, etc.).
When resuming a more upright position, the patient should move carefully to avoid orthostatic
hypotension.
4. Explain the rationale for changing JQ’s diuretic.
 Hydrochlorothiazide is a diuretic thiazide (water pill) that prevents your body from absorbing
too much salt and can induce fluid retention. Triamterene is a potassium-sparing diuretic that
also prevents your body from absorbing too much salt and keeps your potassium levels low. The
reason for changing his diuretic is because the first medication doesn’t seem to have much
desirable effects on JQ, hence they added the triamterene.
5. Should JQ receive a potassium supplement? Explain your answer.
 No. Patients with potassium levels of 2.5-3.5 mEq/L may only require oral potassium
replacement; if potassium levels are less than 2.5 mEq / L, intravenous potassium should be
given with close monitoring, continuous ECG monitoring, and serial potassium level
measurements.
6. What nursing interventions should the nurse follow for JQ?
 Interventions:
-Give with food or milk if GI upset occurs.
-Mark calendars or provide other reminders of the drug for an alternate day or 3-5 days/wk
therapy.
-Reduce dosage of other antihypertensives by at least 50% if given with thiazides; readjust
dosages gradually as BP responds.
-Administer early in the day so increased urination will not disturb sleep.
-Measure and record weights to monitor fluid changes.
7. What care plan should the nurse develop for JQ in relation to patient teaching?
 Nursing Care Plan:
 Assessment
 History: Allergy to thiazides, sulfonamides; fluid or electrolyte imbalance; renal or liver
disease; gout; SLE; glucose tolerance abnormalities, diabetes mellitus;
hyperparathyroidism; manic-depressive disorders; lactation, pregnancy
 Physical: Skin color, lesions, edema; orientation, reflexes, muscle strength; pulses,
baseline ECG, BP, orthostatic BP, perfusion; R, pattern, adventitious sounds; liver
evaluation, bowel sounds, urinary output patterns; CBC, serum electrolytes, blood
glucose, LFTs, renal function tests, serum uric acid, urinalysis
 Intervention
-Give with food or milk if GI upset occurs.
-Mark calendars or provide other reminders of the drug for an alternate day or 3-5
days/wk therapy.
-Reduce dosage of other antihypertensives by at least 50% if given with thiazides;
readjust dosages gradually as BP responds.
-Administer early in the day so increased urination will not disturb sleep.
-Measure and record weights to monitor fluid changes.
 Teaching points
-Record intermittent therapy on a calendar, or use prepared dated envelopes. Take drugs
early so increased urination will not disturb sleep. The drug may be taken with food or
meals if GI upset occurs.
-Weigh yourself regularly, at the same time, and in the same clothing; record weight on
your calendar.
-You may experience these side effects: Increased urination volume and frequency;
dizziness, faintness on rising, drowsiness (avoid rapid position changes, hazardous
activities, such as driving, and alcohol); sensitivity to sunlight (wear sunglasses,
protective clothing, or use a sunscreen); decreased sexual function; increased thirst
 (sucking on sugarless lozenges and frequent mouth care may help); gout attack (report
any sudden joint pain).
-Report weight change of more than 3 pounds in 1 day, swelling in your ankles or fingers,
unusual bleeding or bruising, dizziness, trembling, numbness, fatigue, muscle weakness,
or cramps.
8. What medical follow-up care is needed for JQ?
 As indicated, a follow-up examination should be conducted. Keep track of all appointments. JQ’s health
care practitioner should keep a close eye on his condition, particularly his electrolyte levels. As well as
therapy efficacy.

LEARNING ACTIVITY 2: CROSSWORD PUZZLE

1. Carbonic anhydrase inhibitor

2. Furosemide

3. Natriuresis

4. Aldosterone

5. Hyperglycemia

6. Osmolality

7. Mannitol

8. Hyperkalemia

9. Diuresis

10. Hypertension

11. Hyperkalemia

12. Oliguria