Susan B. Fowler

HOPE AND A HEALTH-PROMOTING LIFESTYLE IN PERSONS WITH PARKINSON'S DISEASE

&NA; The purpose of this study was to determine relationships between hope and a bealth‐promoting lifestyle in adults with varying stages of Parkinsons disease (PD) using a descriptive, correlational design, The sample of 42 adults. recruited from a PD educational symposium and support groups. completed the Herth Hope Index (HHI) and Health‐Promoting Lifestyle Profile II (HPLP II). Significant correlations were found between hope and a total bealth‐promoting lifestyle and spiritual growth and interpersonal relations subscales. Higbest subscale means were in interpersonal relations and nutrition and the lowest mean was in physical activity. Despite a chronic, progressive neurological disease. adults in this study perceived themselves as hopeful and engaged in a health‐promoting lifestyle.

Health-related quality of life in patients undergoing anterior cervical discectomy fusion.

Outcomes are an integral part of surgical decision making among patients, families, physicians, and nurses. The purpose of this descriptive, longitudinal study was to investigate and compare health-related quality of life as an outcome measure in patients undergoing anterior cervical discectomy and fusion (ACDF). Data were collected preoperatively, and at 6 weeks and 3 and 6 months postoperatively. Potential participants were identified by staff members at two neurosurgical practices in central New Jersey. Findings revealed improved health over time with significant change in 6 of the 9 subscales of health-related quality of life. Cervical disk disease and ACDF impact health-related quality of life. A holistic approach to the education and support of patients undergoing ACDF surgery is recommended throughout the preoperative and postoperative periods.

Metabolic syndrome: contributing factors and treatment strategies.

Metabolic syndrome is associated with increased risk for cardiovascular and cerebrovascular disease. The World Health Organization and National Cholesterol Education Program Adult Treatment Panel III have identified physiologic abnormalities associated with metabolic syndrome, including impaired glucose metabolism, high blood pressure, elevated cholesterol levels, and abdominal obesity. It is estimated that 47 million Americans have metabolic syndrome. A variety of therapies may help reduce the incidence and risk, including diet, weight loss, physical exercise, glycemic control, and pharmacological treatments. Nursing care is focused on developing an individualized plan of care that includes family members and providing education, psychosocial support, close monitoring, and continued follow-up to ensure adherence and success in achieving patient outcomes.

Pharmacological interventions for agitation in head-injured patients in the acute care setting.

Agitation following head injury challenges nurses to provide patient safety and participation in daily care and therapies. Diagnosis of the underlying disorder which causes agitative behavior is essential for rapid and successful treatment. A combination of pharmacological and nonpharmacological interventions are required to achieve this expected outcome. Propofol, lorazepam, midazolam and haloperidol are medications most commonly utilized in this patient care situation. The patients sedation level should be monitored to avoid oversedation which may interfere with respiration and neurological status. Nurses need to understand the actions and adverse effects of these agents in order to advocate their proper usage in the agitated head-injured population.

HEALTH PROMOTION IN CHRONICALLY ILL OLDER ADULTS

&NA; As the average life expectancy increases, older adults will be living longer with chronic illnesses. Health promotion is a multidimensional concept that applies to all individuals regardless of age or disability. As the needs of bealthcare consumers change, neuroscience nurses are challenged to redefine health, aging, disability and bealth promotion. Strategies are needed to expand the knowledge base of health promotion including research, partnerships and communication.

Acute stress disorder: application to families of head-injured patients.

&NA; Families of head‐injured patients may respond to the critical nature of the situation with anxiety and cognitive dissociation. This reaction may be classified as an acute stress disorder (ASD). Symptoms may occur 2–28 days after exposure to a traumatic event. Under‐standing this problem allows nurses to target assessment and interventions that focus on decreasing stress and facilitating coping.

Predictive value of biochemical markers in stroke.

Biochemical markers of cerebral ischemia and subsequent inflammation represent a potential diagnostic and predictive modality in acute ischemic stroke. Measurement of these markers may improve clinical functions ranging from diagnosis of ischemic stroke to prediction of functional outcome at 3 months. Predictive models, using various biochemical markers, continue to be investigated.

Management of lipid disorders for stroke prevention

Lipid disorders are common among stroke patients, many of whom also have coronary artery disease. Cholesterol, a lipid, plays a major role in the development of plaque and resulting atherosclerosis. Understanding laboratory values, stroke risk, pharmacological management, and lifestyle modifications associated with lipid disorders is critical to improving care for stroke patients with lipid disorders.

Continuous duodenal infusions of levodopa.

Infusion of carbidopa/levodopa or levodopa through a duodenal tube can facilitate increased mobility and functional ability in individuals with Parkinsons disease when conventional drug therapy is unsuccessful in achieving desired outcomes. Therapy requires appropriate patient selection, ongoing assessment of the patients physical and emotional needs and collaboration between the patient, nurses and physicians. Determining the amount of medication required to achieve the desired outcomes takes time. Implantable pumps may be a future strategy. Future research should focus on patient and family coping throughout hospitalization and at home so the emotional needs of this specific population can be met.

Challenges in patient and family care following an unsuccessful suicide attempt

&NA; According to the dictionary, challenge is a stimulating or interesting task or problem.12 But neuroscience nurses can offer a more comprehensive definition, especially in the context of caring for a patient and their family after an unsuccessful suicide attempt. This situation stimulates our thinking about why individuals try to take their lives, how suicide is attempted and what we, as nurses, can do to turn a bopeless situation into one of hope.