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題名:一位陣發性心室上頻脈合併休克個案之急診護理經驗
書刊名:健康照護科學雜誌
作者:林芳儀吳云湘黃麗華
作者(外文):Lin, Fang-iWu,Yun-hsianhHuang, Li-hua
出版日期:2020
卷期:2
頁次:頁48-56
主題關鍵詞:陣發性心室上頻脈休克同步整流電擊
原始連結:連回原系統網址new window
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本文探討一位陣發性心室上頻脈併休克症狀意識清楚個案之急診護理經驗,個案不僅須面對疾病所帶來的生理威脅,亦須於短時間內克服並接受雙向波同步整流電擊治療之恐懼,引發筆者想幫助個案渡過生、心理護理問題之危機。主要照護期間為2018 年3 月12 日,筆者運用Gordon 十一項健康功能型態進行評估,以直接照護、身體檢查、觀察、會談、查閱病歷等方式收集資料,確立個案有「心輸出量減少」、「恐懼」及「疼痛」之護理問題。在護理過程中,會診第二專科醫師給予建議,並運用行動裝置協助個案強化疾病認知,運用急症專業知識「高級心臟救命術之急救流程」協助醫師執行雙向波同步整流電擊,維持心輸出量;提供個別性之護理措施,給予宗教支持提供心靈寄託緩解焦慮、恐懼,以及運用轉移注意力及傾聽之方式降低疼痛,最終個案克服恐懼,接受雙向波同步整流電擊,順利協助個案渡過危機,穩定其生命徵象。急診醫護人員需有高度敏感辨識心律之變化,運用專業知識給予適當的護理措施,提供良好的照護及整體性護理,故建議優化資訊系統輔助醫護團隊完全正確執行高級心臟救命術之相關急救流程提升病人安全及提供優質照護品質;期望此急診護理經驗能提供護理同仁臨床照顧之參考。
This article discusses the experience of emergency nursing in a paroxysmal supraventricular tachycardia with shock symptoms awareness cases. The case must not only face the physical threat caused by the disease but also must overcome and receive bidirectional wave synchronous rectification shock treatment in a short time. The fear caused the author to want to help the case survive the crisis of physical and psychological care problems.The main period of care was March 12, 2018. The author used Gordon 11 Health Patterns for evaluation and collected data through direct care, physical examination, observation, interviews, and medical records. Established cases have nursing problems of "decreased cardiac output", "fear" and "pain".During the nursing process, the consultation second specialist doctor gave advice, and used mobile devices to assist patients to strengthen disease awareness, and used emergency professional knowledge " Advanced Cardiac Life Support" to assist physicians to perform two-way wave synchronous rectification shock to maintain cardiac output; Provide individual nursing measures, provide religious support, provide spiritual support to alleviate fear, and reduce the pain by diverting attention and listening. In the final case, overcome the fear, accept the synchronous rectification shock, and successfully assist the case to survive the crisis and stabilize her life. Emergency medical staff need to be highly sensitive to identify changes in heart rhythm, use professional knowledge to provide appropriate nursing measures, provide good care and holistic care, so it is recommended to optimize the information system to assist medical teams to fully implement the advanced first aid procedure related to advanced cardiac lifesaving Patient safety and quality of high-quality care; It is expected that this emergency nursing experience can provide a reference for clinical care of nursing colleagues.
期刊論文
1.明金蓮、洪曉佩(20110500)。急性疼痛評估與症狀護理。源遠護理,5(1),11-16。  延伸查詢new window
2.林永國(2016)。青壯年猝死病例多半跟心律不整有關。健康世界,470,55-57。  延伸查詢new window
3.曾文宏、謝昌成、簡振宇(20160500)。心悸的評估、處理與轉介。家庭醫學與基層醫療,31(5),153-156。  延伸查詢new window
4.Bezna, M. C.、Carstea, D.、Bezna, M.、Deliu, C. I.、Alexandru, D. O.、Ciurea, P.(2015)。Clinical Study Regarding Arrhythmogenic Risk Factors and Oxidative Stress Inductibility in Young People。Current Health Sciences Journal,41(3),251-259。  new window
5.Facco, E.、Zanette, G.、Favero, L.、Bacci, C.、Sivolella, S.、Cavallin, F.、Manani, G.(2011)。Toward the validation of visual analogue scale for anxiety。Anesthesia Progress,58(1),8-13。  new window
6.Page, R. L.、Joglar, J. A.、Caldwell, M. A.、Calkins, H.、Conti, J. B.、Deal, B. J.、Al-Khatib, S. M.(2016)。2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia。Circulation,67(13),e27-e115。  new window
7.Warise, L.(2015)。Understanding cardiogenic shock: A nursing approach to improve outcomes。Dimensions of Critical Care Nursing,34(2),67-78。  new window
8.Yancy, C. W.、Jessup, M.、Bozkurt, B.、Butler, J.、Casey, D. E.、Drazner, M. H.、Wilkoff, B. L.(2013)。2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines。Circulation,128(6),1810-1852。  new window
研究報告
1.行政院衛生福利部(2018)。106年國人死因統計結果。  延伸查詢new window
學位論文
1.林竹萱(2014)。心房顫動與心室上心律不整之偵測(碩士論文)。國立臺灣大學。  延伸查詢new window
圖書論文
1.方妙君、杜玲(2015)。心臟血管系統疾病病人之護理。內外科護理學。台北市:華杏。  延伸查詢new window
2.楊久滕(2016)。有症狀的心搏過緩或過速的處置。ACLS精華。金名。  延伸查詢new window
 
 
 
 
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