運用心臟復健照護一位充血性心衰竭患者之護理經驗

A Nursing Experience of Providing Cardiac Rehabilitation Care for a Heart Failure Patient

曾憶美(I-Mei Tseng)；邱秀娟(Hsiu-Chuan Chiu)；江錦玲(Jiin-Ling Jiang)

心臟衰竭 ； 活動無耐力 ； 心臟復健 ； cardiac rehabilitation ； heart failure ； lack of physical endurance

志為護理-慈濟護理雜誌

13卷2期（2014 / 04 / 01）

101 - 110

繁體中文

本文為運用心臟復健照護一位心衰竭患者之護理經驗，護理期間自2010年08月20日至08月31日。以Gordon十一項功能性健康型態為評估工具，經觀察、會談、身體評估及直接照護方式，收集個案資料分析整理後,確立個案的主要問題有「體液容積過多」、「活動無耐力」、「焦慮」等健康問題。護理過程中，以用藥、限制水分、呼吸次數、聲音及四肢水腫情形的評估改善心衰竭；有計畫的執行心臟復健活動，配合飲食及藥物治療，以漸進式方式增進個案心肺功能；用主動關懷及同理的態度，使個案在鼓勵與監督下以緩和方式增進心臟活動耐力及功能。個案於2010年08月31日出院，期望降低病人再住院率。願此次照護經驗，能夠與同儕分享

This report described a nursing experience of providing cardiac rehabilitation care for a patient with congestive heart failure. The nursing period lasted from August 20 to August 31, 2010. With Gordon's functional health patterns as an evaluation tool, data were collected through observation, interview, physical assessment and direct care, and the analysis confirmed the following major health problems: Excess body fluid accumulation, lack of physical endurance and anxiety. During the nursing process, medication, meetings, fluid intake limitation, evaluation of breathing frequency, sound and peripheral edema were used as indicators to assess the improvement heart failure symptoms. Systematic execution of cardiac rehabilitation activities in conjunction with dietary and medicinal therapy was applied to progressively enhance the patient's cardiopulmonary functions. We also provided active care with empathy, together with encouragement and supervision, to facilitate a gentle improvement of the patient's cardiac endurance and function. The patient was discharged on August 31, 2010 with an expectation of reduced readmission rate. We wish to share the nursing experience as a reference for peers when facing similar cases.