照顧一位鬱血性心衰竭個案之護理經驗

鬱血性心衰竭是慢性複雜的疾病，患病過程除了身體功能衰退，亦會影響心理及社會層面。本文是描述護理鬱血性心衰竭個案之經驗，經由評估、觀察、筆談、會談與醫療團隊討論等方式收集相關資料，運用Gordon十一項健康功能評估進行分析，確立個案有氣體交換功能障礙、體液容積過量、焦慮、知識缺失等健康問題，針對上述之問題，密切監測生命徵象、氧合狀況，給予呼吸照護；監測體液輸出入量減輕心臟負荷，改善生命危象；讓家屬參與照護及陪伴，減輕焦慮；針對個案因為不了解疾病而自行停藥的問題，協同個案及家屬共同學習相關知識及照護，再執行護理措施後，個案病情改善轉出加護病房。期望提供此照護經驗，共同提昇病患自我照護能力，預防再入院。

關鍵字

心衰竭；護理

並列摘要

Congestive heart failure is a chronic and complicated disease. In addition to the decline in physical function, patients' psychological health and social relationships are also affected. This study describes the nursing experience of taking care of a patient with congestive heart failure in an intensive care unit. Relevant information was collected from patient evaluations, observations, conversations through correspondence, interviews, and discussion with the medical team. The patient's health assessment was performed using Gordon's 11 functional health patterns. The patient suffered from health problems such as gas exchange dysfunction, fluid volume excess, anxiety, and knowledge deficit. In response to the health problems mentioned above, the patient's vital signs and oxygenation status were closely monitored, the patient was provided with respiratory care, and the patient's fluid input and output was monitored to reduce cardiac load and improve life crisis. The patient's family was allowed to provide care and keep the patient's company to reduce the patient's anxiety. Because the patient had once discontinued medication due to a lack of knowledge of the disease, relevant knowledge and care were provided to the patient and the patient's family. After nursing measures were taken, the patient's disease condition improved, and the patient was discharged from the intensive care unit. It is hoped that this nursing experience can facilitate patient's self-care ability and prevent readmission.

並列關鍵字

Congestive Heart Failure ； Nursing

國際替代計量

照顧一位鬱血性心衰竭個案之護理經驗

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