一位初次罹患急性心肌梗塞個案重症護理經驗

Nursing Care of a Patient with First-Time Acute Myocardial Infarction, a Case Study

張淑勤(Shu-Chin Chang) ； 李彩緣(Chai-Yuan Lee)

《澳門護理雜誌》 11卷2期 (2012/12) Pp. 38-43

摘要

本文在探討一位初次因胸口劇烈疼痛而突然面臨急性心肌梗塞個案之重症護理經驗。護理期間藉由護理評估、會談、觀察方式收集資料，運用Gordon十一項健康功能型態評估，確立個案主要護理問題有「心肺組織灌流改變」、「急性疼痛」、「焦慮」。於照護過程中，針對個案給予足夠的氧氣輔助，衛教採絕對臥床休息及避免便秘以減少心肌耗氧；運用背部熱敷後按摩，並於背部及腰下墊一個小軟枕以支托腰背部，幫助肌肉放鬆及舒展背肌，協助個案改善生理疼痛；並持續提供個案關懷、陪伴、傾聽及心理支持，引導個案抒發內心焦慮感受，運用衛教技巧主動提供相關訊息，緩解內心的焦慮。期望此護理經驗，提供護理同仁在照護此類病患時，能提供病患個別性的護理照護。

關鍵字

急性心肌梗塞 ； 重症護理

並列摘要

This article presented the nursing experience of critical care for a patient who experienced a life-threatening acute myocardial infarction (AMI) following severe chest pain for the first time. The nursing assessment data was collected by physical assessment, interviews and observation. The nursing-related issues, including changes in cardiopulmonary tissue perfusion, acute pain and anxiety, were then identified by using Gordon's 11 functional health patterns assessment. The patient's anoxia was alleviated after the patient was provided with sufficient oxygen. The patient was given health education to understand the need for absolute bed rest and avoidance of constipation. Massage was given on his back after a hot fomentation and a small soft pillow was used to support the lower back to relieve physical pain. In addition, the patient was encouraged to express the anxious feeling by keeping with the provisions of caring, companionship, listening and psychological support. The provision of healthcare knowledge and related information was helpful to alleviate his anxiety.

並列關鍵字

acute myocardial infarction ； critical care