照顧一位心臟瓣膜置換手術患者之護理經驗

Nursing Experience of a Patient Receiving Heart Valve Replacement Surgery

本篇為心臟瓣膜置換手術個案之護理經驗，護理期間包括2007年9月26至29日加護照護，病房探視和電訪，藉由觀察、會談及身體評估收集資料。運用羅氏適應模式為依據，確立有高危險性感染、急性疼痛、活動無耐力、健康尋求行為及家庭運作過程改變等護理問題，以無菌技術換藥避免感染，教導傷口支托技巧，執行心肺復健，藥物衛教指導，給予心理支持，運用社會資源等護理，最後個案肯配合心肺復健運動，使家庭正常運作，達到身心及家庭適應的狀態。

The article described nursing experience of a patient who received heart valve replacement surgery during September 26-29, 2007. Observation, interview, and physical assessment were performed under Roy’s model. The problems were high-risk for infection, pain, activity intolerance, health seeking behavior, and altered family processes. The interventions included changing dressings, supporting wound, planning cardiopulmonary rehabilitation, instructing anticoagulation, providing mental support, and using social resources. Finally, the patient could participate rehabilitation, make family process working, and reach psychosomatic and family comfortable status.