一位行冠狀動脈繞道手術患者術後之護理經驗

Experience of Postoperative Nursing of a Patient Underwent Coronary Artery Bypass Graft Surgery

林意菁(Yi-Ching Lin) ； 李彩緣(Chai-Yuan Lee)

《澳門護理雜誌》 11卷2期 (2012/12) Pp. 32-37

摘要

本文描述一位正值壯年男性病患，罹患冠狀動脈疾病接受冠狀動脈繞道手術之護理過程。照護期間運用Gordon十一項健康功能評估，藉由直接護理、觀察會談、身體評估方式收集資料，加以分析整理，確立個案有急性疼痛、皮膚完整性受損、活動性無耐力、焦慮護理問題。在照護過程中，藉此主動關懷、溝通與個案及家屬建立良好護病關係，以同理心的態度引導個案表達內心感受，利用心理支持及提供放鬆技巧，減輕個案焦慮及疼痛。同時提供計劃性的心肺復健衛教及適當的運動訓練，增進個案心肺功能，以促進日後自我照顧能力，並針對術後傷口提供完善傷口照護，改善傷口感染問題，讓個案能儘快回復正常生活。

關鍵字

冠狀動脈繞道手術 ； 心肺復健 ； 護理經驗

並列摘要

This article presents the experience of postoperative nursing for a male patient in his middle adulthood who underwent coronary artery bypass graft (CABG) surgery due to coronary artery disease. During the nursing period, Gordon's 11 Functional Health Patterns Assessment was applied to analyze the subjective and objective data collected by nursing practice, observatory interview as well as physical assessment. The patient's conditions related to nursing care, including acute pain, impaired skin integrity, activity intolerance and anxiety, were evaluated. A good nurse-patient relationship was established by care initiatives and skillful communications with the patient and his family. Expression of patient's personal feeling was encouraged by empathetic attitude. Relief of anxiety and pain in the patient was improved by psychological support and relaxation. The cardiopulmonary function and self-care capabilities were promoted by programmed training of cardiopulmonary rehabilitation and adequate exercises. Furthermore, comprehensive wound care was applied to prevent potential consequent risk of infection, enabling the patient to resume his normal life sooner as a result.

並列關鍵字

coronary artery bypass graft urgery ； eardiopulmonary rehabilitation ； nursing experience