Questioning of patients

Pharyngitis is the most common disease produced by S. pyogenes. Penicillin-resistant isolates of this organism have yet to be observed. The preferred oral therapy is with penicillin V, 500 mg every 6 hours for 10 days. Equal results are produced by the administration of 600,000 units of penicillin G procaine intramuscularly once daily for 10 days or by a single injection of 1.2 million units of penicillin G benzathine. Parenteral therapy is preferred if there are questions of patient compliance. Penicillin therapy of streptococcal pharyngitis reduces the risk of subsequent acute rheumatic fever but not of poststreptococcal glomerulonephritis. 

Questioning of patients motive in seeking open disclosure. 

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 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... 

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. 

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. 

In patients with chronic asthma, question the patient concerning allergies, frequency of attacks, severity of attacks, factors that cause or relieve attacks, and any antiasthma drugs used currently or taken previously. 

Before administering the first dose of warfarin, die nurse questions the patient about all drags taken during the previous 2 to 3 weeks (if the patient was recendy admitted to the hospital). If the patient took any drug before admission, the nurse notifies the primary healdi care provider before the first dose is administered. Usually, the prothrombin time (PT) is ordered and die international normalized ratio (INR) determined before tiierapy is started. The first dose of warfarin is not given until blood for a baseline PT/ INR is drawn. The dosage is individualized based on die results of the PT or die INR. 

When evaluating die effectiveness of acetazolamide (Diamox) given for acute glaucoma, die nurse questions the patient about. ... 

When a UTI has been diagnosed, sensitivity tests are performed to determine bacterial sensitivity to the drugp (antibiotics and urinary anti-infectives) that will control the infection. The nurse questions the patient regarding symptoms of the infection before instituting therapy. The nurse records the color and appearance of the urine. The nurse takes and records die vital signs. A urine sample for culture and sensitivity is obtained before the first dose of the drug is given. 

During the preadministration assessment, the nurse reviews the patient s chart for the medical diagnosis and reason for administration of the prescribed drug. The nurse questions the patient regarding the type and intensity of symptoms (such as pain, discomfort, diarrhea, or constipation) to provide a baseline for evaluation of the effectiveness of drug therapy. 

At the time of each office or clinic visit, the nurse questions the patient regarding the occurrence of adverse reactions and records the patient s vital signs and weight. 

ANDROGEN HORMONE INHIBITOR The nurse questions the patient at length about symptoms of BPH, such as frequency of voiding during the day and night and difficulty starting tire urinary stream. The nurse records all symptoms in the patient s chart. 

Educating the Patient and Family The treatment regimen is explained to the patient and family (when appropriate). The nurse answers any questions the patient may have regarding treatment. The patient is instructed to report any adverse reactions. The patient and family are informed of therapeutic response during administration of the drug. If nasal spray is to be used, the patient is taught proper use ... 

A related issue is the question of which patients to include in an evaluation. The most usefirl evaluation would be one that included all patients likely to use a service in the real world. However, in order to make evaluations feasible, and because of the need to achieve the informed consent of patients, many prospective clinical trials exclude certain patient groups. For example, many schizophrenia trials exclude patients with... 

Some have questioned the specificity of DWI in delineating particular areas of the brain that are destined for infarction, noting that some DWI lesions resolve at least partially in follow-up studies. However, it appears that reversibility of DWI lesions is quite unusual and typically involves only a small portion of initially abnormal tissue. One study found that reversal of a DWI abnormality occurred in 33% of patients following intra-arterial thrombolysis. However, in this study, the areas of reversal nevertheless went on to infarction in the majority of patients. ... 

Author Publication Design Number of Patients Clinical Question Outcome... 

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