一位產後婦女經歷周產期心肌病變之護理經驗

Care Experience of a Postpartum Patient Undergoing Peripartum Cardiomyopathy

潘明(Ming Pang) ； 謝青芳(Ching-Fang Hsieh) ； 邵上智(Shang-Chih Shao)

《高雄護理雜誌》 34卷3期 (2017/12) Pp. 80-92

https://doi.org/10.6692/KJN.201712_34(3).0008

摘要

本文描述一位35 歲產後婦女經歷周產期心肌病變(Peripartum Cardiomyopathy, PPCM)的護理經驗。護理期間為2016 年3 月25 日至3 月28 日，筆者藉由觀察、身體評估、會談等方式進行資料收集，運用羅氏適應模式進行評估，確立個案有氣體交換障礙、睡眠型態紊亂與母乳哺餵中斷等護理問題。護理過程中針對周產期心肌病變導致的心因性肺水腫，依據其個別性擬定護理措施，改善急性期呼吸狀態，減緩心臟負荷，提供放鬆技巧、音樂聆聽等方式，改善重症個案的睡眠品質。急性期所面臨的哺乳中斷，引導個案表達情緒並傾聽關懷其需求，提供母乳哺餵的資訊，以建立未來母乳哺餵的計畫。期望藉此罕見個案的護理經驗，作為護理人員照護上的參考。

關鍵字

周產期心肌病變 ； 母乳哺餵中斷 ； 氣體交換障礙 ； 睡眠型態紊亂

並列摘要

This case report aimed to explore an experience of caring for a 35-year-old postpartum patient undergoing peripartum cardiomyopathy. During the nursing period from 25th March, 2016 to 28th March, 2016, the author determined the primary nursing problems including gas exchange disorder, sleeping pattern disturbance and interrupted breastfeeding, by using Roy’s adaptation model, which is based on observation, physical assessment and interview for data collection. Through this nursing process for PPCM-related acute lung edema, it was possible to help the patient improve respiratory pattern and alleviate cardiac loading by providing individual nursing interventions, and sleep quality was improved by providing the patient with relaxation techniques and music. We guided this patient to express herself and become concerned about her demands, as well as providing information of breastfeeding with her to set a breastfeeding schedule. It is hoped that this nursing experience could be shared with everyone and serve as a reference for nursing staff to look for similar cases in the future.

並列關鍵字

peripartum cardiomyopathy ； interrupted breastfeeding ； gas exchange disorder ； sleep pattern disturbance

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