- 期刊
照顧一位腎衰竭併心臟衰竭行瓣膜手術術後患者之加護經驗
Post-operative Nursing Experience for a Uremia Patient with Valvular Heart Failure in the Intensive Care Unit
摘要
本文描述一位腎衰竭個案罹患二、三尖瓣閉鎖不全併心衰竭，接受手術的加護經驗。護理期間由2009年10月14日至10月19日，運用會談、觀察、病歷查閱及Gordon十一項健康功能型態評估，確立個案有氣體交換障礙、急性疼痛、活動無耐力和無力感等健康問題。依個別性、整體性，擬定護理計畫，以維持正常氧氣飽和濃度、輸出入量平衡和呼吸訓練，改善氣體交換問題；術後適當的疼痛護理，減輕疼痛不適；增強術後心肺復健動機，緩解活動無耐力；運用傾聽、陪伴、主動關懷及衛教，協助個案克服無力感的心理問題，使其轉出加護病房，順利出院返家。加護中心之照顧不僅改善威脅個案生命的生理健康問題，也透過關懷，協助個案克服生命中的幽谷，展現整體性護理的功能。
並列摘要
In this article, we describe our experience in post-cardiac surgery critical care for a uremic case with congestive heart failure due to regurgitation of mitral and tricuspid valves. During the period of nursing care from 14th to 19th October 2009, health data information was obtained through interviews, observation and review of charts while the data collection framework was evaluated based on Gordon's Eleven Functional Health Patterns. Nursing problems established in this patient were defect in oxygen exchange, acute pain, exercise intolerance, and a sense of powerlessness. Taking into consideration the individual needs of our patient as a whole, we drew up nursing care plans aiming to solve the above-mentioned problems. We monitored her oxygen saturation and fluid balance, and performed respiratory training to improve her gaseous exchange, reduced her acute pain through application of adequate post-operative nursing care, and motivated her to participate in a post-operation cardiopulmonary rehabilitation program, which gradually alleviated her exercise intolerance. Through health education, listening, keeping her company, and taking an initiative in expressing care, we helped to overcome her sense of powerlessness after cardiac surgery, and she was transferred from the intensive care unit and returned home smoothly. Intensive care unit attendance can not only minimize the danger of physiological health questions, but also enhance caring, assist the patient to overcome these difficulties in her life, and enable integrity of the nursing function become more pervasive.
延伸閱讀
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