急性心肌梗塞病患之急診護理經驗─個案報告

Emergency Nursing Experience of Acute Myocardial Infarction: A Case Report

馮子瑄(Tzu-Hsuan Feng) ； 詹尚易(Shang-Yih Chan)

《北市醫學雜誌》 15卷3期 (2018/09) Pp. 52-62

https://doi.org/10.6200/TCMJ.201809_15(3).0006

摘要

本文敘述一位49歲男性因急性心肌梗塞接受心導管治療之急診護理經驗。運用Gordon十一項健康功能評估、觀察、會談及健康評估方式收集資料，確立健康問題有：心輸出量減少、急性疼痛及焦慮。護理期間監測病人組織灌流不足徵象、心電圖變化及評估藥物療效，讓個案在照護期間維持血液動力學穩定、血氧飽和度達95%以上且無心律不整情形；協助舒適臥位及教導放鬆技巧，讓個案的疼痛分數由8分降為3分；運用陪伴、引導及協同醫療團隊澄清疑問及分享成功案例，使個案能說出焦慮感減輕，進而正向面對疾病，同意接受心導管介入治療。

關鍵字

急性心肌梗塞 ； 心輸出量減少 ； 急性疼痛 ； 焦慮

並列摘要

This report describes the nursing experience of caring a 49-year-old man with acute myocardial infarction receiving primary cardiac catheterization in emergency room. Data was collected using the Gordon's eleven health function assessments, observations, interviews, and health assessments. Health problems were identified: decreased cardiac output, acute pain, and anxiety. We monitored the tissue perfusion signs, ECG changes and drug efficacy carefully to keep the patient in a more stable hemodynamic status and blood oxygen saturation of 95% or more. In addition, we taught the patient relaxation skills and helped adjusting his lying position which decreased his pain score from 8 to 3. We established a companionship with the patient; we clarified questions in coordination with the care team and shared successful cases with the patient; we encouraged the patient to express his anxiety on the disease and face the disease positively. After this, he agreed to receive the cardiac catheterization.

並列關鍵字

acute myocardial infarction ； decrease cardiac output ； acute pain ； anxiety