Nursing Care for Patients with Ischemic Heart Disease Undergoing Percutaneous Coronary Intervention (PCI) : case study

บทคัดย่อ

Abstract

            Introduction : Ischemic Heart Disease (IHD) is a significant global and national health issue in Thailand, ranking among the leading causes of death. Percutaneous Coronary Intervention (PCI) is one treatment method that reduces mortality rates and long-term complications. Nursing care for IHD patients undergoing PCI focuses on the nursing process, nurses' skills, and competencies, encompassing physical, mental, and social aspects to minimize complications, prevent readmission, and enable patients to return to a joyful life with their families and society.

            Objective : To study the nursing care of IHD patients who underwent PCI in the Pre-Post Catheterization Unit.

            Methods : A comparative study of two patients admitted to the Pre-Post Cath Unit was conducted using interviews, observations, and medical records.

            Results : Both patients presented with similar symptoms, including chest tightness and throat discomfort radiating to the jaw and left shoulder that lasted 10 – 30 minutes. They underwent 12-lead electrocardiography (EKG) and laboratory tests (Troponin I). Both were diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI) and required antiplatelet therapy, anticoagulants, and coronary angiography. However, they differed in comorbidities, health behaviors, PCI catheterization sites, post-procedural complications, and risk factors. Both patients received standardized nursing care emphasizing the nursing process, guided by Gordon’s Functional Health Patterns and Orem’s Nursing Theory, covering admission, pre-procedure, post-procedure, follow-up, and discharge phases. Case 1: Challenges included disease complexity, risky behaviors (diet, medication, exercise), and potential restenosis. Case 2: Challenges involved restenosis at a previously treated site, lack of exercise, and insufficient sleep. Both patients safely passed the critical phase without severe complications.

Keywords : Ischemic Heart Disease , Percutaneous Coronary Intervention, Nursing Care, Orem’s Theory