Patients expectations

After the nursing diagnoses are formulated, the nurse develops expected outcomes, which are patient oriented. An expected outcome is a direct statement of nurse-patient goals to be achieved. The expected outcome describes the maximum level of wellness that is reasonably attainable for the patient. For example, common expected patient outcomes related to drug administration, in general, include ... 

With instructions like these, one might expect patients to become angry or insulted, to refuse to take the pills or at least to feel sceptical, even if reluctant to express their scepticism. 

Carmen is a pale 20-year-old lady. Like many cystic fibrosis patients, she was diagnosed when she was a baby her problem was suspected when she suffered repeated respiratory infections and failed to gain weight as expected. Patients with cystic fibrosis secrete a high concentration of NaCl in their sweat and this forms the basis of an early diagnostic test for the condition. 

Successful postmarket data collection, like premarket clinical trials, relies on physicians and patients to follow prescribed social norms. Each of the institutions described here tried to structure the doctor-patient relationship to produce objective and interpretable reports about drugs outside of the controlled clinical setting. In both countries, government authorities and the medical profession expected patients to recognize adverse reactions, assist physicians in reporting them to central authorities, and then continue to take other prescription drugs. However difficult it may be to discipline patients to report adverse reactions, physicians too must be trained to complete and submit forms. A standardized product requires a standardized producer. Authorities... 

Beclometasone, fluticasone and sodium cromoglicate are effective in relieving all nasal symptoms of hayfever. They take some days to achieve optimum effect, and treatment should ideally be started at least 2 weeks before symptoms are expected. Patients should be advised that, if symptoms are already present when treatment is started, it could be several days before an effect is noted and several weeks before full relief is obtained. 

The alternate MTF should be a building or a large tent near the hospital and should be in telephone and radio contact with the hospital. Some hospitals have elected to turn the hospital cafeteria into this facility however, this creates a problem of where to feed the hospital staff. Admission to this alternate MTF should be limited to minimal and delayed (nontraumatic injury) patients. This is the perfect place for the walking worried. Depending on the scope of the event, a second, altemative MTF may be used for expectant patients. The hospital facility can then devote its attention to the treatment of immediate and delayed (traumatic) patients. 

An example will now be presented. In the development of a new drug, plasma concentration data were collected from 24 subjects at times 0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 18, 24, 36, and 48 h postdose. From this data, the noncompartmental estimate of AUC was calculated. Of particular interest to the researchers was whether one or two samples early on in the timecourse of the kinetic profile of the drug could be used to predict AUC. Since it was problematic to expect patients to remain at the clinic longer than 4 h, the data set was limited to the first 4-h postdose. 

An example of the results of such an application are shown in Table 4.7. For this exemplar study, 920 responses were collected from inpatients and outpatients in a big university hospital located in Tokyo (Itoh et al. 2006). Patient responses were compared with those collected from 33 doctors working in this hospital. This table shows comparative results for the mild and severe outcome cases in terms of pereerrtages of doctors who reported that they worrld - arrd patients who indicate that they think the doctors would - defirritely or probably perform each of the three actiorrs described. There were significarrt differences for all reaction items in both severity cases. A large gap can be seen between doctors irrdications of their reactions and patients expectations. Patients are more sceptical of staff reactions after an adverse event than doctors responses suggest they need to be. 

Mollin (1954) would not expect patients with pernicious anemia in remission given 50 Mg- (labeled with Co ) to absorb nearly as much as this through the agency of intrinsic factor, and Glass et al. (1954) found that normal persons given 50 Mg- absorbed only about 1.5 Mg-... 

Expectant patients are those whose injuries are so severe that attempting to save them would divert precious resources from other casualties with a greater chance of survival, with no significant chance of a successful outcome. The decision to invoke the expectant category must be taken at silver level and preferably only after discussion with gold command. 

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