Nursing evaluation
Ask the patient's past and present medical history, whether there is discomfort, the causes and inducing factors of arrhythmia; To understand the types, attack frequency, duration, therapeutic effect and influence on patients' daily life of arrhythmia; Evaluate the clinical manifestations of arrhythmia, such as palpitation, chest tightness, fatigue, dizziness, syncope, etc. And the changes of consciousness and circulation of patients.
Whether the patient is nervous because of discomfort such as chest tightness, palpitation and fatigue caused by arrhythmia, and pays too much attention to his pulse; Whether patients with atrial fibrillation have embolism due to thrombus shedding, which makes them disabled, sad and anxious; Whether the patient has fear during tachycardia attack; Self-care degree of patients with severe atrioventricular block. How do people who install artificial pacemakers know about medical teaching, education, network collection and self-care, and are they depressed or lack of confidence?
Common nursing diagnosis and cooperation between doctors and nurses
1. Exercise intolerance: related to decreased cardiac output and tissue ischemia and hypoxia caused by arrhythmia.
2. Anxiety is related to recurrent arrhythmia and lack of confidence in treatment.
3. Potential complications: sudden death
Nursing goal
The patient's activity endurance increased; Relieve or control anxiety and actively cooperate with treatment; The dangerous signs of arrhythmia can be found and treated in time, and no sudden death has occurred.
Nursing measures
(1) ordinary care
1. Rest patients should ensure adequate rest and sleep when arrhythmia attacks cause palpitation, chest tightness, dizziness and other symptoms, and avoid lying on the left side during rest to prevent discomfort caused by heartbeat when lying on the left side.
2. Diet gives foods rich in cellulose to prevent constipation; Avoid full meals and irritating foods, such as coffee and strong tea.
(2) Observe the condition and connect the ECG monitor, continuously monitor the changes of heart rate and rhythm, and find dangerous signs as soon as possible. Timely measure vital signs, measure pulse 1 min, and listen to heart rate. When patients have frequent multi-source premature ventricular contractions, front-end premature ventricular contractions, ventricular tachycardia, second-degree type II and third-degree atrioventricular block, inform the doctor in time and cooperate with the treatment. Monitor electrolyte changes, especially blood potassium.
(3) Rescue equipment (such as defibrillators, electrocardiographs, ECG monitors, temporary pacemakers, etc.). ) and various antiarrhythmic drugs and other rescue drugs, ready for rescue.
(4) When using antiarrhythmic drugs in medication and nursing, closely observe the effects and adverse reactions of the drugs to prevent the occurrence of toxic and side effects.
(5) Nursing of Interventional Therapy Introduce the purpose and methods of interventional therapy such as radiofrequency catheter ablation or pacemaker implantation to patients, so as to eliminate their nervousness and make them actively cooperate with the treatment. And do a good job in the corresponding nursing of interventional therapy.
(6) Health guidance
1. Explain the causes and common inducing factors of arrhythmia to patients, such as emotional tension, overwork, acute infection, cold stimulation, and bad living habits (smoking, drinking strong tea and coffee).
2. Guide patients to combine work and rest and live a regular life. People without organic heart disease should take an active part in physical exercise. Maintain emotional stability and avoid mental tension and excitement. Change bad eating habits, quit smoking and drinking, and avoid strong tea, coffee, cola and other irritating foods. Keep defecation unobstructed, and avoid defecation force to aggravate arrhythmia.
3. Explain the name, dosage, usage, function and adverse reactions of the drugs used by patients, and guide patients to insist on taking drugs, and do not arbitrarily increase or decrease the dosage or types of drugs.
4. To teach patients and their families the methods of measuring pulse, the treatment measures of arrhythmia and cardiopulmonary resuscitation, so as to facilitate self-monitoring and self-rescue. Explain the methods of self-monitoring and home care for pacemaker patients.
5. Regularly review the electrocardiogram and follow-up, and see a doctor in time if any abnormality is found.
Nursing evaluation
The patient's activity endurance is enhanced, and appropriate measures can be taken to alleviate the discomfort caused by the decrease of cardiac output; Relieve or relieve anxiety; Vital signs were stable and no sudden death occurred.