急性心肌梗塞行冠狀動脈氣球擴張術病患之急診護理經驗

Emergency Care Experience in a Patient with Acute Myocardial Infarction Underwent Coronary Angioplasty

本文敘述一位66歲首次罹患急性心肌梗塞個案，在急診啟動急性心肌梗塞救護團隊，並緊急接受冠狀動脈氣球擴張術之個案，在急診等待加護病房的護理經驗。筆者於2009年5月7日至5月12日護理期間，運用觀察、會談、病史資料收集及Gordon十一項健康功能型態等方式來評估個案的健康問題，確立個案主要問題有：心肺組織灌流改變、特定的知識缺乏及焦慮等，在急診護理過程中，運用適當的護理措施：症狀護理、疾病相關衛教、主動適時的陪伴和給予心理支持等措施，並運用急性心肌梗塞和冠狀動脈氣球擴張術之學理為依據，配合醫囑給藥和治療，解除個案身心不適之症狀。本文藉由分享個案的護理經驗，期盼能提供同領域的護理人員往後在照顧急性心肌梗塞病人能有更深一層的認識與了解，以提升急診護理專業之照護品質。

This article described the nursing care for a 66-year-old patient who suffered from acute myocardial infarction since he was transferred back to our observation room waiting for admission in cardiac care unit after receiving percutaneous transluminal coronary angioplasty. Through observation, interview, medical history-taking and evaluation of the Gordon 11 functional health patterns during his stay in the observation room from 2009 May 7th to 12th , the following nursing problems were revealed: the changes of tissue perfusion status, the lack of specific knowledge, and anxiety. Adequate nursing care in the emergency department included symptoms care, disease-related health education, timely and initiative companionship for patient, and psychological support. Appropriate nursing management according to medical prescriptions and the standard scientific principles of coronary angioplasty for acute myocardial infarction were offered. Through sharing of the experience, the objective of this article was to improve the understanding of the concept of acute myocardial infarction among as well as the standard of professional services and quality of care.