PLAN DE INGRIJIRE AL BOLNAVULUI CU INSUFICIENTA CARDIACA CONGESTIVA –PRIMA ZI DE SPITALIZARE NEVOIA
NEVOIA DE A RESPIRA SI A AVEA O BUNA CIRCULATIE
NEVOIA DE A EVITA PERICOLELE
DIAGNOSTIC DE INGRIJIRE Alterarea activitatii cardiace c !caderea ei dat"rita #e"$i%e#arii &i"cardli 'cardi"(atie i!c)e&ica cr"#ica &a#i*e!tata (ri#+ ,di!(#ee la e*"rtri &ici-)i("$e&ie-ede& e cardiace-cia#".a cardiace-cia#".a e$tre&itatil"r
Alterarea c"#*"rtli 2.ic !i (!i)ic &a#i*e!tata (ri# !tare dea%itatie-#eli#i!te*acie! cri!(at(al(itatii-tra#!(iratii
OBIECTIVE
INTERVENTII
Cre!terea Cre!terea ada(ta/ilitatii la activitatea cardiac red!a
,&"#it"ri.e. !e&#ele de activitate cardiac'(l! TA0-!i TA0-!i alt"r *#ctii vitale 'te&(eratra 'te&(eratra !i re!(iratie01 ,"/!ervarea "/"!elii-"di)#ei-drerii t"racice1 ,a!e. (acie#tl i# (".itie !e&i!e.a#da1 !e&i!e.a#da1 ,edc (acie#tl !a ,!i crea!ca tre(tat activitatea 2.ica-!a alter#e.e re(a!l c "di)#a-!a # *"l"!ea!ca !area i# e$ce!-!a &a#a#ce (ti# !i *recve#t1 ,ad&i#i!tre. "$3%e# ,ad&i#i!tre. &edicatia (re!cri!a ,rec"lte. !a#%e (e#tr a#ali.e ,e*ecte. E4G ,i#!"te!c (acie#tl la radi"l"%ie (e#tr e*ectarea radi"%ra2ei t"racice1
Pacie#tl Pacie#tl !a /e#e2cie.e de i&/#atatirea !tarii de c"#*"rt (ri# i#tele%erea ttr"r &a#i*e!taril"r 2.ice !i (!i)ice !i a &"dli de ada(tare la ace!tea>
,a!i%r c"#ditii de &edi adecvate-i#latra#d adecvate-i#latra#d *act"rii #e%ativi- care ar (tea i#@e#ta !tarea (acie#tli1 ,i#crae. (acie#tl !a c"&#ice c cei di# r !i !a ceara at"rl at#ci ca#d are #ev"ie1 ,cree. # &edi "(ti& (e#tr ca (acie#tl !a ("ata e$(ri&a e&"tiile-te&erile -#ev"ile1 ,!(rave%)e. (acie#tl !i il at !a i!i rec#"a!ca rec#"a!ca #eli#i!tea1 ,di!ct cal& c (acie#tl (e#tr a,I ca!ti%a
EVALUARE TA56789:8 TA56789:8 &&;% Pl!588 R5<< re!(9&i# Val"ri a#ali.e????> Pacie#tl a i#tele! #ece!itatea re!(ectarii re%i&li de ada(tare la #"ile c"#ditii i%ie#", dietetice i&(!e de /"ala-de!i rec#"a!te ca ii e!te *"arte %re> Pacie#tl (re.i#ta " a&eli"rarea a !tarii de c"#*"rt >
i#crederea !i ii ra!(#d la t"ate i#tre/arile re*erit"are la /"ala -i# li&itele c"&(ete#tei &ele1 ,(re%ate!c (!i)ic (acie#tl i#ai#tea "ricarei te)#ici !a i#ve!ti%atii1 ,a!i%r " i%ie#a c"re!(#.at"are (e#tr a,i crea " !tare de /i#e1 ,#"te. .il#ic di!(".itiile !rve#ite i# !tarea (acie#tli>
NEVOIA DE A ELIMINA
NEVOIA DE A DORMI SI A SE ODI;NI
E$ce! al v"l&li lic)idia# dat"rita alterarii ra("rtli i#%e!ta9e$creta &a#i*e!tat (ri# cre!tere i# %retate-acce#tarea di!(#eei la e*"rtri &icia#$ietate-ede&e-di!t e#!ia ve#el"r %lare
Alterarea !"&#li calitativ !i ca#titativ &a#i*e!tat (ri# i#!"&#ie de ad"r&ire- tre.iri
Me#ti#erea )idratarii "r%a#i!&li i# li&ite #"r&ale
Pacie#tl !a /e#e2cie.e de !"&# li#i!tit !i !2cie#t ca#titativ !i calitativ>
,deter&i# !i &"#it"ri.e. .il#ic %retatea !i TA1 TA5689:&&; ,evale. c"&("rta&e#tli % (acie#tli'i#%e!tie-e$cretie de lic)ide01 G5>> ,edc (acie#tl !i *a&ilia a!(ra re%i&li Re!(56re!(9&i ali&e#tar !i de viata1 # ,&"#it"ri.e. re!(iratia - a!(ectl te%&e#tel"r Ede&ele !,a ede&atiate1 &ai red!> ,i#*"r&e. (acie#tl a!(ra c"&(licatiil"r ,te%&e#tele deter&i#ate de e$ce!l de lic)ide1 !#t ,ad&i#i!tre. c"rect &edicatia (re!cri!a1 i#te%re> ,edc (acie#tl !a rec#"a!ca !e&#ele de (ierdere de 4 dat"rita a("rtli e$a%erat de diretice ce deter&i#a de(letia de 4'"/"!eala-cra&(e &!clar-c"#*.ii-(al(itatii01 ,re!tricti"#e. a("rtl de lic)ide c"#*"r& (re!cri(tiei &edicli> ,i#*"r&e. (acie#tl c (rivire la ali&e#tele care adc # a("rt de ("ta!i> ,cree. # cli&at de i #credere- i#crae. !i li#i!te!c Pacie#tl are # (acie#tl (e#tr a,!i reca(ata ec)ili/rl (!i)ic1 !"&# ,*av"ri.e. "di)#a (acie#tli (ri# !(ri&area i&/#atatit !r!el"r care,I ("t crea di!c"#*"rt !i irita/ilitate1 ca#titativ'8,7 ,"/!erv !i #"te. calitatea !i "rarl !"&#li-%radl "re0-dar #
*recve#te-*acie! "/"!it c "c)i i#cerca#ati>
de !ati!*acere al cel"rlalte #ev"i1 ,!ti&le. i#crederea (acie#tli i# *"rtele (r"(rii !i i# (er!"#all de i#%riire1 ,"/!erv daca (acie#tl d"ar&e i# ti&(l .ilei !i #"te. #&arl de "re de !" ,i#vat (acie#tl te)#ici de rela$are !i e$ercitii re!(irat"rii (e care !a le (ractice c 6 &i#te i#ai#te de clcare1 ,"/!erv !i #"te. t"ate !c)i&/arile care !rvi# i# !tarea (acie#tli -a##ta#d &edical>
re!e!te !a !e "di)#ea!ca !2cie#t> Pacie#tl acce(ta i#%riirile !i c"&#ica e2cie#t c (er!"#all de i#%riire>
