急性心肌梗塞併發心因性休克患者之護理經驗

Nursing Experience of a Patient with Acute Myocardial Infarction Complicating Cardiogenic Shock

本文描述於加護病房照顧一位急性心肌梗塞併發心因性休克患者，歷經病痛與死亡威脅而引起焦慮不安之護理過程。護理期間90年7月14日至90年7月29日，筆者以戈登(Gordon)十一項功能性健康評估技巧，確立護理問題有心肺組織灌流改變、焦慮、體溫過高、健康尋求行為等。因個案為首次心肌梗塞發病，心中充滿不安及不確定感，筆者運用傾聽、關懷、人性化護理、靈性照護、家庭壓力模式護理、放鬆治療、心臟復健衛教，並尊重個案自主性，與個案及家屬建立良好的治療性人際關係，成功地緩解個案生理上的痛苦和內心的焦慮。於醫療團隊共同努力下，個案能瞭解患病原因及後續自我照顧，於8月7日康復出院，並持續接受追蹤治療。The article describes the nursing experience in caring a patient who had acute myocardial infarction complicated with cardiogenic shock, experienced fear of illness and death with anxiety. During July 14 to July 29,2000, the researcher applied Gordon 11 functional health status assessment instrument, and confirmed the patient had nursing problems as follows: altered tissue perfusion of cardiopulmonary system, anxiety, hyperthermia, health- seeking behavior, etc. Because this was the first time the patient suffered from acute myocardial infarction, he felt uneasy and uncertain. The author used methods of listening, humanized solicitude, spiritual care, family stress model nursing, as well as relaxation treatment, the investigator also provided knowledge of cardiac rehabilitation, and respected patient's autonomy. The author not only built up a good interpersonal relationship with the patient and his family but also successfully relieved his physical suffering and inner anxiety. Under medical team's collaborating efforts, the patient not only understood pathogenesis and self care but also got restored and was discharged on August 7, He received follow-up treatment.