Dietary therapy education

Carol had hired a local clinical pharmacist who had expertise in ambulatory care as a consultant to assist with the pharmacists education and skills development. The clinical consultant facilitated the case discussions. The cases that were developed for this program required pharmacists to assess and modify patients dietary habits and activity levels. Also, they needed to identify and develop plans for resolving drug therapy problems. They practiced writing recommendations to physicians on the physician communication form. 

Monitoring of volume status and serum electrolyte levels should be done at each follow-up visit in patients with Stages 4 or 5 CKD, particularly given the risk and detrimental consequences of volume overload (e.g., hypertension and pulmonary edema) and hyperkalemia (e.g., arrhythmias). Changes in volume status may warrant a change in diuretic therapy or dialysis regimens required to maintain hemodynamic stability. Patients should be educated on modifications in dietary intake and self-evaluation for signs and symptoms of edema. 

Education, psychotherapy, well-balanced meals and snacks, regular exercise, dietary changes (e.g., limiting caffeine, alcohol, and salt), relaxation therapy, stress reduction, and sleep hygiene are first-line nonpharmacologic approaches for menstruation-related disorders. 

Both of Ms. Jeina s younger brothers had very high serum cholesterol levels, and both had suffered heart attacks in their mid-forties. With this information, a tentative diagnosis of familial hypercholesterolemia, type IIA was made, and the patient was started on a step I diet as recommended by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. This panel recommends that decisions with regard to when dietary and drug therapy are initiated based on the serum LDL cholesterol level, as depicted in Table 34.1. 

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