一位急性心肌梗塞復發合併心因性休克個案之急診護理經驗

Emergency Care Experience in a Patient with Recurrent Acute Myocardial Infarction Complicated by Cardiogenic Shock

李芳儀(Fang-Yi Li) ； 賴琦琇(Chi-Hsiu Lai)

《志為護理-慈濟護理雜誌》 17卷4期 (2018/08) Pp. 105-116

摘要

本文描述一位46歲男性長期處於高壓力工作環境，因急性心肌梗塞復發併心因性休克入急診之護理經驗，照護期間為2013年6月10日10：41至2013年6月10日11：20，在有限時間內，首重團隊合作效能的發揮，方能讓筆者運用身體評估、會談、觀察、病歷翻閱等方法，收集主、客觀相關資料，以Gordon健康模式為評估指引，確立主要健康問題為(1)組織灌流改變、(2)急性疼痛、(3)焦慮、(4)知識缺失。根據急性心肌梗塞及經皮冠狀動脈氣球擴張術之學理，配合醫囑進行症狀治療，協助面對生心理上的不適，照護過程中訂立適切可及之護理目標，給予個別性的護理措施，使得個案獲得完善的照護，期盼分享此篇護理經驗，以提供同仁參考。

關鍵字

急性心肌梗塞 ； 心因性休克 ； 急診護理經驗

並列摘要

This article describes a nursing experience of a 46 years old male patient who had worked in a high-stress working environment over a prolonged period of time and was admitted due to recurrent AMI complicated by cardiogenic shock. The caring period is from 10:41 a.m. to 11:20 a.m., June 10^(th), 2013. Within a limited timeframe, the effective team work allowed the author to collect relevant subjective and objective data via physical assessment, interviews, observation, and record review, and with Gordon's functional health patterns as an assessment framework, established the following main health issues: 1) ineffective tissue perfusion; 2) acute pain; 3) anxiety; and 4) knowledge deficit. Based on the theories of acute myocardial infarction (AMI) and percutaneous transluminal coronary angioplasty (PTCA), treatment was performed in accordance with the doctor's diagnosis to assist the patient in adjusting to the physical and psychological discomfort. For the patient to receive the best care, appropriate nursing goals were set during the nursing period to provide individualized care. We hope to share this nursing experience as a reference for other nursing staff to enhance nursing quality when facing similar situation.

並列關鍵字

AMI ； cardiogenic shock ； emergency care experience