[간호학] 고려대학교 안암병원 72W CS에 대한 자료입니다.
Ⅰ. Ischaemic heart disease
1) Ischaemic heart disease
2) CABG surgery
2) 실제 case와 scenario 비교
Ⅲ. Concept mapping
1) Concept mapping
Ⅳ. Nursing process
1) 고립으로 인한 사회적 접촉의 부족과 관련된 고립감
2) 혈당 수치 불안정 및 운동부족과 관련된 피부손상
3) 스트레스와 관련된 수면장애
4) 당뇨식이에 대한 지식부족 및 간호사와의 rapport 미형성과 관련된 치료요법의 비효율적 이행
5) 수술 후 회복지연과 관련된 감염의 위험성
Ⅰ. Ischaemic heart disease
Ischaemic heart disease
Ischaemic heart disease (IHD), or myocardial ischaemia, is a disease characterized by ischaemia (reduced blood supply) of the heart muscle, usually due to coronary artery disease (atherosclerosis of the coronary arteries). Its risk increases with age, smoking, hypercholesterolaemia (high cholesterol levels), diabetes, and hypertension (high blood pressure), and is more common in men and those who have close relatives with ischaemic heart disease.
Symptoms of stable ischaemic heart disease include angina (characteristic chest pain on exertion) and decreased exercise tolerance. Unstable IHD presents itself as chest pain or other symptoms at rest, or rapidly worsening angina. Diagnosis of IHD is with an electrocardiogram, blood tests (cardiac markers), cardiac stress testing or a coronary angiogram. Depending on the symptoms and risk, treatment may be with medication, percutaneous coronary intervention (angioplasty) or coronary artery bypass surgery (CABG).
It is the most common cause of death in most Western countries, and a major cause of hospital admissions. There is limited evidence for population screening, but prevention (with a healthy diet and sometimes medication for diabetes, cholesterol and high blood pressure) is used both to prevent IHD and to decrease the risk of complications.
The medical history distinguishes between various alternative causes for chest pain (such as dyspepsia, musculoskeletal pain, pulmonary embolism). As part of an assessment of the three main presentations of IHD, risk factors are addressed. These are the main causes of atherosclerosis (the disease process underlying IHD): age, male sex, hyperlipidaemia (high cholesterol and high fats in the blood), smoking, hypertension (high blood pressure), diabetes, and the family history.
Signs and symptoms
Ischaemic heart disease may be present with any of the following problems:
Angina pectoris (chest pain on exertion, in cold weather or emotional situations)
Acute chest pain: acute coronary syndrome, unstable angina or myocardial infarction ("heart attack", severe chest pain unrelieved by rest associated with evidence of acute heart damage)
Heart failure (difficulty in breathing or swelling of the extremities due to weakness of the heart muscle)
The diagnosis of ischaemic heart disease underlying particular symptoms depends largely on the nature of the symptoms. The first investigation is an electrocardiogram (ECG/EKG), both for "stable" angina and acute coronary syndrome. An X-ray of the chest and blood tests may be performed.
Myeloperoxidase has been proposed as a biomarker.
3. 최영희 등, 『간호진단과 간호중재』, 현문사
4. 최순희 등, 『표준화된 간호진단(NANDA) 결과(NOC) 중재(NIC)의 연계』, 현문사