A guarded prognosis indicates that a patient is acutely ill with a questionable outlook and a small chance for improvement, reports the Baltimore Sun. "Guarded" is also often used by nurses and doctors who are unable to declare whether a patient can successfully recover from an illness.
Part of a lexicon developed to keep a patient's family and friends informed, "guarded" is usually synonymous with "serious" and "poor," says Phyllis Brill of the Sun, with the implication that neither the doctor nor the nurse are able to judge how a patient might fare. For example, a critically ill patient whose vital signs remain stable may receive a guarded prognosis because his condition might worsen.
The Maryland Hospital Association's handbook provides doctors and nurses with a glossary of patient conditions that the medical community generally agrees upon, with conditions ranging from good to critical. However, Brill also reports that these terms can be vague or misleading, especially as a patient's condition declines. Doctors and nurses do not consider these terms a true medical prognosis but instead as a way of providing a patient's friends and family with a take on his short-term health. Dr. James Ricely has criticized their use, pointing out that they are used only to satisfy a demand and fail to convey accurate information.