Patients questioning

The patient consultation center of the prescription department provides an area for patients and the pharmacist to discuss medications and related patient questions. The consultation center may be as small as an 18-inch window built into the prescription counter or as large as a freestanding patient care center. Patient care centers provide pharmacy staff with a place to offer counseling and medical information and provide screenings for various disease states, therapeutic drug monitoring, and immunizations. 

As with economic data, clinical information can be collected from primary and secondary data sources. Primary data can be collected at the point of care, when the pharmacist sees the patient. Primary data collection is the most reliable method of collecting clinical information because it provides the most control over the data collection process. The pharmacist can ask patients questions, perform necessary laboratory tests, conduct physical assessments, and record information either electronically or on paper. 

Table 5.3 Common patient questions related to anthrax and suggested answers...

Fmit and vegetable juices high in potassium have been recommended to correct hypokalemic alkalosis in patients on diuretic therapy. Apparendy the efficacy of this treatment is questionable. A possible reason for ineffectiveness is the low Ck content of most of these juices. Because Ck is high only in juices in which Na" is high, these have to be excluded (64). 

The use of a bioadhesive, polymeric dosage form for sustained dehvery raises questions about swallowing or aspirating the device. The surface area is small, and patient comfort should be addressed by designing a small (less than 2 cm ), thin (less than 0.1 mm (4 mil) thick) device that conforms to the mucosal surface. The buccal route may prove useful for peptide or protein dehvery because of the absence of protease activity in the sahva. However, the epithelium is relatively tight, based on its electrophysiological properties. An average conductance in the dog is 1 mS/cm (57) as compared to conductances of about 27 and 10 mS/cm in the small intestine and nasal mucosa, respectively (58,59) these may be classified as leaky epitheha. 

Day after day, patients appear in the pharmacy asking for a herbal tea for a particular kind of condition. When the pharmacist asks the routine question whether a simple" herbal tea or a special mixed tea or a tea bag or an instant tea is wanted, mostly the stereotyped answer comes back You know which is the best one. Give me that one ... 

The answers to all questions are not known with certainty, and research toward the solution of such problems will require the combined efforts of the plastic chemist and designer with the physician. It is through the efforts of such multidiscipline groups that surgical repair materials of outstanding longterm utility are produced, studied, evaluated, and made available to the patient. 

The nurse must use judgment about when adverse drug reactions are reported to the primary health care provider. Accurate observation and evaluation of the circumstances are essential the nurse should record all observations in the patient s record. If there is any question regarding the events that are occurring, the nurse can withhold the drug but must contact the primary health care provider. 

When obtaining the drug history, the nurse must always question the patient about the use of herbs, teas, vitamins, or other nutritional or dietary supplements. Many patients consider herbs as natural and therefore safe It is also difficult for some to report the use of an herbal tea as a part of the health care regimen. Display 1-4 identifies teaching points to consider when discussing the use of herbs and nutritional supplements with patients. Although a complete discussion about the use of herbs is beyond the scope of this book, it is important to remember that the use of herbs and nutritional supplements is commonplace in many areas of the country. To help the student become more aware of herbal therapy and nutritional supplements, Appendix B gives... 

The nurse can evaluate die patient s or family s understanding of die drug regimen by noting if one or bodi appear to understand die material that has been presented. Facial expression may indicate diat one or bodi do or do not understand what has been explained. The nurse also may ask questions about die information diat has been given to further evaluate die patient s or family s understanding. 

Questions such as Do you understand or Is there anything you don t understand should be avoided because die patient may feel uncomfortable admitting a lack of understanding. When factual material is being evaluated, the nurse should periodically ask the patient to list or repeat some of die information presented. 

Promoting an Optimal Response to Therapy Because these dru may be used in the treatment of certain types of severe and sometimes life-threatening viral infections, the patient may be concerned about the diagnosis and prognosis. The nurse should allow the patient time to talk and ask questions about methods of treatment, especially when the drug is given IV. It is important to explain the treatment methods to the patient and family members. 

The ongoing assessment involves careful observation of the patient every 2 to 4 hours for adverse drug reactions when the antifungal drug is given by the oral or parenteral route. When these dru are applied topically to the skin, the nurse inspects the area at the time of each application for localized skin reactions. When these dm i are administered vaginally, the nurse questions the patient regarding any discomfort or other sensations... 

The diagnosis of a helminth infection is often distressing to patients and their family. The nurse should allow time to explain the treatment and future preventive measures, as well as to allow the patient or family members to discuss their concerns or ask questions. 

DISTUR0ED SENSORY PERCEPTION VISUAL. The patient taking chloroquine may experience a number of visual disturbances, such as disturbed color vision, blurred vision, night blindness, diminished visual fields, or optic atrophy. The nurse questions die patient about visual disturbances. 

The nurse obtains the patient s history, that is, a summary of the disorder, including onset, symptoms, and current treatment or therapy, hi some instances, it may be necessary to question patients regarding their ability to carry out activities of daily living, including employment when applicable. 

When developing a teaching plan for the patient and family, tlie nurse emphasizes the importance of uninterrupted drug therapy. The nurse allows the patient and family time to ask questions. The nurse explores any problems that appear to be associated with tlie prescribed drug regimen and then reports them to tlie primary health care provider. The nurse reviews tlie purpose of tlie drug therapy with tlie patient and family, as well as the adverse reactions that may occur. 

When the patient is an outpatient, the nurse observes the patient for a response to therapy at the time of each clinic visit. In some instances, the nurse may question the patient or a family member about die response to therapy. The type of questions asked depends on the patient and die diagnosis and may include questions such as How are you feeling, Do you seem to be less nervous, or Would you like to tell me how everything is going Many times the nurse may need to rephrase questions or direct the conversation toward other subjects until these patients feel comfortable and are able to discuss their dierapy. 

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