照護年輕急性心肌梗塞病患之我見

Nursing Experience of a Young Patient with Acute Myocardial Infarction in the Critical Care Unit

本文主要探討一位年輕的急性心肌梗塞患者的加護照護經驗。筆者經由Gordon十一項功能性健康型態進行整體性評估與會談，發現有疼痛、現存性出血、高危險性活動無耐力、焦慮等問題。在護理過程中除了給予急性期照護外，也注意到導致患者焦慮的不確定感來源，予適當的解釋與衛教以解除焦慮，且協助患者確實執行心臟復健及人生規劃的修改。唯主治醫師未能同步安排患者做心臟復健致後續護理指導受限，故建議未來在護理學校及在職教育中能安排心臟復健相關課程，使護理人員在臨床上不僅能教導心肌梗塞患者心臟復健，且能提醒其出院後，也須至復健科門診做持續性的心臟復健，以獲得更有品質的生活。

The purpose of this article is to illustrate the case of a young acute myocardial infarction patient with many problems (such as , pain, active/high risk for bleeding, high risk for activity intolerance and anxiety) by Gordon 11 health-physiological scale. During the process of nursing, the nurses offered the patient not only the critical care, but also health education and a suitable explanation of his treatment and situation in order to release his anxiety. Furthermore, the nurses assisted the patient to do cardiac rehabilitation and modify his life p1an. But the limitation was that the doctor in charge didn't arrange the cardiac rehabilitation for the patient. The author suggests to offer the cardiac rehabilitation related courses in the nursing school and on-the-job training for nurses in the future. The training will assist nurses in teaching the patients with myocardial infarction both to do cardiac rehabilitation well and to have treatment in the Physical Medicine and Rehabilitation Outpatient Services continuous1y as a result to rise the quality of the patient's life