Heart & lung : the journal of critical care
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Case Reports
Atypical presentation of varicella-zoster virus encephalitis in an immunocompetent adult.
Varicella-zoster virus encephalitis is uncommon, but not rare, in immunocompetent adults. Typically, patients develop stroke with hemiplegia caused by large vessel vasculopathy days to weeks after herpes zoster ophthalmicus. ⋯ This is a case of varicella-zoster virus encephalitis in an immunocompetent patient presenting without typical rash and with clinicoradiologic features of multifocal encephalitis, which characterize immunosuppression.
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The objective was to study patients' interpretations, thoughts, and actions after symptom onset in acute coronary syndrome (ACS) in total and in relation to gender, age, history of coronary artery disease, type of syndrome, and residential area and its influence on prehospital delay. ⋯ Interpreting symptoms as cardiac in origin and approaching someone after symptom onset were major reasons for a shorter prehospital delay in ACS.
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We know little about long-term exercise behavior and adherence in patients with chronic obstructive pulmonary disease (COPD). ⋯ This investigation provides a description of long-term exercise behavior and adherence in a sample of patients with COPD. The categories suggest that physical benefits are related to consistent adherence, whereas mental health improvements are related to regular exercise with some flexibility in the schedule. Future research should test interventions to improve exercise adherence in patients with COPD and identify characteristics of patients who are most likely and least likely to adhere over time.
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Comparative Study
Needs of family members of critically ill patients: a comparison of nurse and family perceptions.
Critical illness often occurs without warning. leaving families feeling vulnerable and helpless with no clear knowledge of what to expect from health care professionals or patient outcome. The challenge for critical care nurses (Registered Nurses [RNs]) is to provide care for aggressively managed, critically ill patients while attending to the needs of stressed family members. ⋯ Family needs were categorized according to Leske's dimensions of assurance, proximity, information, comfort, and support. By implementing specific cost-effective strategies to increase family access to the patient, to improve communication with the physician and the health care team, and to create a family-friendly environment, critical care RNs can meet family member needs and improve the quality of nursing care.