一位裝置永久性心臟節律器患者的護理經驗

Nursing Care of Patient Receiving Implantation of a Permanent Pacemaker

王淑盈(Shu-Ying Wang) ； 賴美玉(Mei-Yu Lai) ； 游顯妹(Xian-Mei You)

《中山醫學雜誌》 19卷2期 (2008/12) Pp. 263-277

https://doi.org/10.30096/CSMJ.200812.0011

摘要

本篇個案報告在探討一位76歲老年患者，接受永久性心臟節律器植入手術前後所面臨的生理及心理問題之護理經驗。護理期間自2006年3月2日至2006年3月5日止，經觀察、會談及查閱病歷方式收集個案相關資料加以分析整理，並運用羅氏適應模式作一整體性評估，確立個案有「組織灌流改變」、「高危險性感染」、「焦慮」及「健康尋求行為」等健康問題。在護理過程中密切監測血流動力學變化，透過護理專業照護讓心臟節律器功能正常以維持足夠的組織灌流，教導個案及家屬傷口照護方法以預防感染，並在出院前共同擬定學習計畫，衛教返家後注意事項及裝置永久性心臟節律器自我照護技巧，及早為返家後自我照顧作準備，成功協助個案減輕焦慮及縮短適應期。

關鍵字

永久性心臟節律器

並列摘要

This article reports a case involving 76-year-old patient with sick sinus syndrome who received permanent pacemaker implantation. Nursing care was provided from March, 02, 2006 to March, 05, 2006. The Roy's adaptation mode was used to collect the data. After observations, interviews, and a review of chart records, the patient's data was collected and analyzed. The case was found to have four problems requiring nursing attention: ”altered tissue perfusion”, ”high risk for infection”, ”anxiety”, and ”health seeking behaviors”. During the nursing period, specific nursing care plans were created to closely monitor hemodynamic change, per pro care was used to ensure normal functioning of the permanent pacemaker function and adequate maintenance of hemodynamics, to educate the patient and his family on wound care and the prevention of infection, to draw up a learning program before hospital discharge, to give instruction to the family regarding matters that need attention after the patient returned home, and to show the patient how to care for himself after the permanent pacemaker was installed. This type of care reduced anxiety and shortened the patient's adaption period.

並列關鍵字

Permanent Pacemaker