一位主動脈瓣狹窄老年病患接受經導管主動脈瓣膜置換及永久性心臟節律器放置治療之護理經驗

This article describes the nursing experience of caring an elderly aortic stenosis (AS) patient who received a transcatheter aortic valve replacement implantation (TAVI) and permanent pacemaker (PPM) implantation. The period of nursing care was from July 3, 2015 to July 15, 2013. The authors collected and assessed the patient's health problems according to the Gordon 11 Functional Health Patterns Method and identified nursing problems such as low cardiac output (due to AS and post-TAVI conduction disorders), powerlessness, and lack of knowledge about taking anticoagulants, wound care, and self-care at home. To manage low cardiac output, nursing interventions were applied to increase the cardiac output, reduce heart workload, and stabilize the vital signs to supply enough blood to the entire body. To treat powerlessness, a nurse-patient relationship was established to encourage the patient to express concern and personal feelings to enhance the patient's own sense of control over her life plans and confidence in her ability to manage her condition. Additionally, the patient was informed about diet and contraindications to anticoagulants, PPM wound care, and other related health education to promote quality of life. Finally, the author hoped this nursing experience can be used as a reference by nursing staff caring similar client in the future.