- 期刊
一位心衰竭合併心因性肺水腫病人之急診護理經驗
The Emergent Care Experience of a Heart Failure Patient with Pulmonary Edema
摘要
本文闡述一位心衰竭合併心因性肺水腫病人之急診護理經驗。照護期間由2016年10月25日23點56分至10月26日03點50分，筆者藉由直接照護、觀察會談、身體評估等方式收集資料，並運用Gordon十一項健康功能型態評估，確立個案有心輸出量減少、氣體交換功能障礙及焦慮三項問題。於急診照護期間，迅速給氧治療、裝置生理監視器、藥物治療、適當限制活動及水份攝取，以改善病人氣體交換障礙及降低心肌耗氧量；個案因呼吸喘而出現生命威脅的焦慮情緒，予以持續監測、主動關懷及說明疾病病程進展的治療方向，引導病人渡過急性期並緩解負面情緒，病況暫穩後轉入加護病房持續治療。筆者期望藉此照護經驗分享，讓急診同仁了解即使個案處於心衰竭的急性發作期，亦能提供整體性的評估與照護，讓個案迅速穩定病況、降低焦慮以接受進一步照護。
並列摘要
This case study describes an emergency nursing experience with heart failure that resulted in pulmonary edema. The intervention period was from January 25, 23:56 PM to January 26, 03:50 AM, in 2017. An assessment was conducted using observation, interview, and the Gordon 11 Function Health Patterns. Three problems were identified as decreased cardiac output, impaired gas exchange, and anxiety. During the period of emergency care, providing immediate oxygen therapy, monitoring physiological functions, delivering medication therapy, restricting activity and supplementing water consumption improved the patient's impaired gas exchange and reduced his myocardial oxygen consumption. When life-threatening shortness of breath is aggravated by anxiety, continuous monitoring, active caring and explaining the progressive conditions could reduce the patient's negative emotions, with temporary stabilization. As a result, the patient was transferred to the ICU for further management. It is hoped that this current experience might serve as an example for enhancing physical assessment, reducing anxiety feelings, and rapidly stabilizing acute congestive heart failure before further care in similar medical settings.
參考文獻
延伸閱讀
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