การพยาบาลผู้ป่วยภาวะหัวใจล้มเหลวร่วมกับโรคหัวใจขาดเลือดเฉียบพลัน ชนิดเอสทีไม่ยกสูง: กรณีศึกษา

Abstract

A Thai male 48 years olds was admitted in male internal medicine inpatient department. He had dyspnea and chest pain for 4 hour. He then was diagnosed for NSTEMI with congestive heart failure. ECG demonstrated ST elevation in lead V2 to V4 which did not significantly change from previous study. He was received diuretic medication intravenously, Aspirin 81 mg (4 tabs) chewed, Clopidegrel 75 mg 4 tabs orally, Enoxaparin 0.6 ml subcutaneously and on oxygen cannula 5 LPM respectively. On the next day, his urine output was decreased and glomerular infiltration rate was declined. His dyspnea symptom progressed severely and also his oxygen saturation dropped to 88 %. Therefore, he was intubated and ventilated via the mechanical ventilator and received added dose of diuretic medication intravenously. On the day after, he was successfully extubated. He had admitted for 5 days and then referred back to community hospital for closed observation and preparation for PCI in the future.

The nurse has an important role to have knowledge and skills in taking of patients especially in critical stage. For examples, the nurse should closely observe patients’ symptoms and focus on monitoring complications of disease until patient was stable and tailor a proper discharge planning for each patient. The nursing in congestive heart failure patients has goals to reduce the mortality and re-admission rates.