照顧一位老年心臟瓣膜術後患者之護理經驗

Postoperative Nursing Care for an Elderly Patient and Heart Valve Disease and Serious Degeneration of Vision

鄭玉亭(Yu-Ting Cheng) ； 郭斐如(Fei-Zu Gao) ； 明勇(Yung Ming)

《高雄護理雜誌》 25卷2期 (2008/11) Pp. 62-74

https://doi.org/10.6692/KJN-2008-25-2-6

摘要

心臟瓣膜疾病為老年族群重要之心臟疾病，其開心手術後出現之併發症、身心調適障礙及日常生活影響遠甚於一般成年人。本文係筆者照護一位72歲男性且視力嚴重退化個案行心臟瓣膜手術後，經由直接照護、訪談、觀察及查閱病歷方式完成資料收集與評估，發現個案健康問題包括急性疼痛、無力感、潛在危險性感染、健康維護能力不足等，因此，針對個案問題運用羅氏適應理論及主動關懷、傾聽、同理心等護理措施，鼓勵個案說出心中感受，給予心理支持並與個案建立良好的護病關係，提供相關資訊和指導，以減輕個案內心之焦慮，改善其術後身心調適問題，使其擁有更好的生活品質。希望藉此個案之護理經驗能供護理人員於日後照護心臟瓣膜術後視障老人之參考。

關鍵字

心臟瓣膜術後 ； 老年護理

並列摘要

Heart valve disease is one of the most complicated conditions among heart diseases in the elderly. The surgeries associated with heart valve disease tend to have more complications, greater psychophysiological disturbance and greater daily life impairment in the elderly and younger adults.
In this case study, we report our experience caring for a 72-year-old patient with heart valve disease s/p valvoplasty. Assessed by means of direct care, interview, observation, and medical record, we found the patient to also suffer from severe degeneration of vision and health problems including acute ache, latent risk infection, and inability to maintain his own heath.
Based on Roy's adaptation theory, nursing care for this patient involved initiative concern, attentive listening to provide psychological support, established a nurse-patient relationship based on trust, correlating information and teaching the patient how to reduce anxiety. This reduced the patient's psychophysiological disturbance and enabled the patient to improve his quality of life.
It is hope that this nursing experience can help better acquaint nurses with the postoperative care of elderly patients or patients with severe vision degeneration.

並列關鍵字

postoperative heart valve ； nursing care for elderly