一位子癲前症初產婦合併心臟衰竭之護理經驗

本文為照顧初產婦因子癲前症引起心臟衰竭入住加護病房之照顧經驗，於2022年1月21日至1月28日藉由觀察、會談、身體評估、病歷查閱等方式，運用Gordon十一項健康功能型態進行評估，確立病人有心輸出量減少、活動無耐力、焦慮等健康問題。照顧期間透過衛教及幫助病人辨別心臟衰竭症狀，提供合適的飲食建議，依醫囑給予利尿劑及氧氣，與病人共同討論及訂定心臟復健方式以增加活動耐力，促進家屬參與復健，於照顧過程提供病人心理支持及陪伴，鼓勵家屬與病人分享新生兒情況，協助病人接受及面對自身疾病，並適應疾病帶來的身體變化，促使病人能早日重新回歸家庭生活。因臨床上較少有照顧心臟衰竭產婦之照顧經驗，建議心臟內科加護病房護理師強化心臟衰竭產婦周全性照護的能力，提升病人的照護品質，並以此照顧經驗分享，提供護理人員未來照護此類病人之參考。

關鍵字

子癲前症；初產婦；心臟衰竭

並列摘要

This article describes the experience of providing nursing care to a primipara with heart failure caused by pre-epilepsy who was admitted to the intensive care unit. The nursing care period was from January 21 to January 28, 2022. The health status of the primipara was assessed using Gordon's 11-item functional health patterns assessment. The assessment revealed the following major health issues: decreased cardiac output, activity intolerance, and anxiety. During the nursing care period, nurses provided health education, helped the patient identify the symptoms of heart failure, provided appropriate dietary advice, and administered diuretics and oxygen as directed by doctors. The nurses discussed with the patient the appropriate cardiac rehabilitation methods to increase her endurance during physical activity and encouraged family members to participate in rehabilitation. The nurses also provided the patient with psychological support and companionship during the care process. In addition, the nurses encouraged the family members to share the situation of the newborn with the patient and helped the patient accept and face her illness and adapt to the physical changes caused by the disease. In doing so, the patient could return to normal life as soon as possible. Because nurses have relatively little clinical experience in caring for a primipara with heart failure, nurses' abilities for providing comprehensive care to such women should be strengthened. This nursing care experience can be used as a reference for caring for such patients in the future.