Patient’s health and

Longitudinal health record A health record that spans across many features of the patient s health and across the patient s entire life, in being essentially lifelong. 

In order to be accepted by the FDA, an in vitro diagnostic sensor must measure a clinically meaningful parameter, and the clinical utility of the sensor must be demonstrated. Clinical utility can mean both the benefit of measuring a parameter to the patient s health and also the cost effectiveness of the assay performed by the sensor. 

Of course, this new focus requires a definition of harm, and the Calgary Health Region has adopted the definition from the College of Physicians and Surgeons of Ontario. Harm is defined as an imexpected or normally avoidable outcome that negatively affects the patient s health and/or quality of life, which occurs (or has occurred) in the course of the patient s illness (CPSO 2003). 

It must be remembered that all anesthetics and tranquilizers are used by the practitioner following a risk—benefit evaluation. General anesthesia, even being adininistered by an experienced practitioner, can result in death through cardiac or respiratory depression. The veterinarian is acutely aware of these risks and chooses the dmg and method of adininistration considering the patient s health status, the nature of and need for the procedure, and the likelihood of success. 

To evaluate die patient s response to tiierapy, and depending on die drug administered, die nurse may check die patient s blood pressure every hour, inquire whether pain has been relieved, or monitor die pulse every 15 minutes. After evaluation, certain otiier decisions may need to be made and plans of action implemented. For example, die nurse may need to notify die primary health care provider of a marked change in a patient s pulse and respiratory rate after a drug was administered, or die nurse may need to change die bed linen because sweating occurred after a drug used to lower die patient s elevated temperature was administered. 

The nurse always listens, evaluates, and reports any complaints die patient may have certain complaints may be an early sign of an adverse drug reaction. The nurse should report all changes in die patient s condition and any new problems that occur (eg, nausea or diarrhea) as soon as possible. It is tiien up to the primary health care provider to decide if tiiese changes or... 

Administration of penicillamine has been associated with many adverse reactions, some of which are potentially serious and even fatal. The nurse carefully evaluates any complaint or comment made by the patient and reports it to the primary health care provider. Increased skin friability may occur, which may result in easy breakdown of the skin at pressure sites, such as the hips, elbows, and shoulders. If the patient is unable to ambulate the nurse changes the patient s position and inspects pressure sites for skin breakdown every 2 hours. 

It is important for the nurse to note the presence of suicidal thoughts. The nurse accurately documents in the patient s record and reports to the primary health care provider any statements concerning suicide and the ability of the patient to carry out any suicide intentions. The nurse performs a physical assessment, which includes obtaining blood pressure measurements on both arms with the patient in a sitting position, pulse, respiratory rate, and weight. 

Behavioral records should be written at periodic intervals (frequency depends on hospital or unit guidelines). An accurate description of die patient s behavior and cognitive ability aids the primary health care provider in planning tiierapy and thus becomes an... 

MAINTAINING ADEQUATE NUTRITION. A special diet (eg, foods high in iron or foods high in folic acid) may be prescribed. If the diet is taken poorly, the nurse notes this on the patient s chart and discusses tiie problem with tiie primary health care provider. 

If the male or female patient is being treated for a malignancy, the nurse enters in the patient s record a general evaluation of the patient s physical and mental status. The primary health care provider may also order laboratory tests, such as serum electrolytes and liver function tests. 

The symptoms of bipolar disorder and the side effects associated with its treatment have implications for the patient s health-related quality of life. The disorder itself has an impact upon mental and emotional wellbeing. Bipolar disorder also affects areas of life such as employment, social partnerships and independence. The side effects of treatment may further impair the quality of life. 

Measure PT/INR every 1 to 4 weeks based on the stability of the INR and patient s health status. 

Typically, health care providers are not able to observe a patient s seizures, and for most types of seizures the patient has no memory of the event. It is important to obtain a careful history from the patient and any individuals who witnessed the seizures. 

Reinforce the importance of regular follow-up with the patient s health care providers including all appointments for follow-up care and lab work (if any). 

Inability to resolve an infection may indicate a mixed infection, infection due to a non-albicans strain, or an infection that is not fungal. Difficulty treating WC can also be indicative of serious underlying conditions, such as diabetes or human immunodeficiency virus (HIV) infection. For these reasons, if infection does not resolve easily with a single course of antifungal therapy or if symptoms return within 2 months, practitioners should check cultures and further evaluate the patient s health status or refer the patient to a physician. 

The first aspect of biocompatibility is a natural immune response. When a foreign object enters the blood stream, it can be attacked by the body s defense system. The first step is protein adsorption on an object surface. It is believed that the amount and type of protein adsorption is one of the most important steps determining whether the object is tolerated or rejected by the body. The next step is cell adhesion, which may cause aggregation and activation of platelets and triggering of the blood coagulation system with resulting thrombus formation. It may not only lead to sensor failure via surface blocking but directly threatens the patient s health. 

Access to health care can be defined in many ways, including by insurance status, number of physician visits in the last year, and treatment interventions once an individual is in the health care system. Furthermore, access can relate to whether the patient s health care is satisfactory, comprehensive, and meeting the overall needs of the patient from a social, cultural, spiritual, or other perspective. 

It seems clear that government as a funding agency and physicians as clinical providers may take race into account when racial correlations with health status or health care are directly relevant. In many clinical situations moral and legal duties to take race into account in order to respond properly to the patient s health needs may also exist, either because of state action or because of state laws banning racial and ethnic discrimination in public accommodations, which include hospitals and physician offices. Three situations in which a physician may have a duty to recognize racial correlations and order a different test or therapy as a result are discussed below. 

All the objectives presented in Box 11.1 can be described as quality improvement in the structure and process to support improvement in each patient s health outcome. This support the patient medication care process presented in Fig. 3.1. Various problems and tools and models for improvement have been described in this book. Another approach to prevent medication errors and to improve care is to be open and continuously learn from mistakes. The basis for this is not to punish health care providers who make errors, as this may lead to less reporting of errors. In Britain, the government has taken steps away from this blame-culture (Wise 2001). In a declaration it is stated that honest failure should not be responded to primarily by blame and retribution, but by learning and by a drive to reduce risk for future patients. 

Mental and physical health professionals may consider referring clients and patients to a music therapist for a number of reasons. It seems a particularly good choice for the social worker who is coordinating a client s case. Music therapists use music to establish a relationship with the patient and to improve the patient s health, using highly structured musical interactions. Patients and therapists may sing, play instruments, dance, compose, or simply listen to music. 

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