從縱貫面探討一位行冠狀動脈繞道手術病人之護理經驗

本文主要從縱貫面探討一位有冠狀動脈心臟疾病行冠狀動脈繞道手術術後的護理經驗，筆者於96年1月3日至96年1月24日期間以觀察、會談、查閱病歷、直接護理等方式及運用紐曼理論模式進行完整性護理評估，確立護理問題為在加護病房期有焦慮、急性疼痛，在普通病房期有活動無耐力，在出院居家期有知識缺失等護理問題。筆者藉由良好的護病關係，提供個案術前護理指導及術後注意事項，減輕住院期間的焦慮及壓力的調適，以正向態度面對此重大手術；於術後嚴密監測生命徵象，給予緩解疼痛及活動無耐力等相關護理處置，針對傷口照護、飲食指導、運動、用藥等居家生活自我照護注意事項，提供個別性的護理指導，轉出加護病房持續追蹤，個案能在活動耐受範圍內執行穿衣服、刷牙、洗臉、進食等日常活動，出院後調整飲食習慣且養成規則運動習慣，以提升手術後之生活品質，並回復工作崗位上，期盼藉由此篇護理經驗提供日後照護類似個案之護理人員參考及分享。

關鍵字

冠狀動脈疾病；冠狀動脈繞道手術；心臟手術後護理

並列摘要

This article describes the three-week nursing care experience of a coronary artery bypass graft (CABG) patient from pre-op, to post-op intensive care unit, to step down unit, to discharge. Based on the Newman model, patient problems included anxiety, acute pain, activity intolerance, and knowledge deficit in self-care. From a therapeutic nurse-patient relationship, the patient received pre-op teaching on what to expect post surgery and to adopt a positive attitude toward surgery. Post-op care in the intensive care unit focused on monitoring the patient's vital signs, controlling post-op pain, and assisting with activity and mobility. Individualized patient teaching included wound care, diet, advancement in exercise and medications. The case follow-up continued after the patient transferred to step down unit and discharge. The patient demonstrated good adjustment to diet, ambulation and self-care activities.

並列關鍵字

coronary artery disease CAD ； coronary artery bypass graft CABG ； nursing care for post cardiac surgery

國際替代計量

從縱貫面探討一位行冠狀動脈繞道手術病人之護理經驗

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