陣發性心室上頻脈之急診護理照護

本文描述一位陣發性心室上頻脈(Paroxysmal Supraventricular Tachycardia; PSVT)個案於急診就醫時發生低血壓、焦慮與知識缺失時的照護經驗。運用Gordon的11項功能性健康評估為架構，利用身體檢查、觀察個案行為反應及會談等方法收集資料，發現個案的主要護理問題為心輸出量減少與心臟電學的因素有關，焦慮與疾病對健康狀態的威脅及不確定感有關；知識缺失與疾病相關資訊不足有關等問題，經由筆者教導個案使用Valsalva方式終止心律不整，在筆者積極探視下鼓勵個案說出問題及感受、給予正向言語回饋，告知疾病特性、發生原因、處理方式及治療方向等護理措施介入後，結果個案在1分鐘後血壓上升至141/80㎜Hg，心跳降低至每分鐘約98次；於出院前口頭表示自己因瞭解PSVT特性、原因及因應方式，當PSVT再次發作時，將害怕降至最低。期望藉此經驗，提供急診醫護人員面對PSVT病患就診過程中之照護參考。

關鍵字

陣發性心室上頻脈；心輸出量減少；焦慮；知識缺失

並列摘要

This report describes a patient who experienced hypotension, anxiety and knowledge deficiency in relation to his disease in the ER. The author used the 11 items of Gordon's Functional Health Pattern Model as an assessment framework and data was collected through direct care, physical assessment, observation and interviewing the patient. We found that the patient had three nursing concerns and these were impaired cardiopulmonary perfusion, anxiety and knowledge deficiency. We taught the patient to use the Valsalva's maneuver and positional feedback to alleviate his arrhythmia. After explaining the characteristics of the disease, the reasons for the disease, how the disease can be managed and what treatments are available for the disease, the patient's blood pressure increased to 141/80 mmHg and the patient's heart rate dropped to 98 beat per minute. The patient said that after realizing the character of the disease and the reasons behind it, together with using the methods to alleviate the symptoms, he was not afraid of the attack anymore. We expect that these findings can apply in the future by other emergency unit nurses.

並列關鍵字

PSVT ； impaired cardiopulmonary perfusion ； anxiety ； knowledge deficiency

國際替代計量

陣發性心室上頻脈之急診護理照護

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