Rehabilitation nursing for an overweight patient with acute respiratory failure and heart failure
一例急性呼吸衰竭合并心力衰竭超体重患者的康复护理

摘要

总结1例急性呼吸衰竭合并心力衰竭超体重患者的康复护理体会。护理要点：实施呼吸肌序贯治疗：高流量氧疗→无创通气→家庭呼吸机过渡，优化通气效率；开展阶梯式运动康复，提升活动耐力；执行精准营养管理，控制体重增长；落实跨学科风险防控；应用SMART目标行为干预增强治疗依从性；其中呼呼吸肌序贯治疗、阶梯式运动康复及体重控制的协同管理是本案例的重点及难点。经系统干预，患者住院4天后好转出院，随访显示肺功能改善、体重下降2kg、自理能力评分升至85分，成功重返工作岗位。

Abstract

This article summarizes the experience of rehabilitation nursing for an overweight patient with acute respiratory failure and heart failure. Key Nursing Points: Implementing sequential respiratory muscle therapy: high-flow oxygen therapy → noninvasive ventilation → transition to home ventilator to optimize ventilation efficiency; implementing stepped exercise rehabilitation to improve activity tolerance; implementing precise nutritional management to control weight gain; implementing interdisciplinary risk management; and applying SMART targeted behavioral intervention to enhance treatment compliance. The coordinated management of sequential respiratory muscle therapy, stepped exercise rehabilitation, and weight control was the key and challenging aspect of this case. Following systematic intervention, the patient improved and was discharged after four days of hospitalization. Follow-up showed improved lung function, a 2kg weight loss, and an increase in self-care ability score to 85 points, with successful return to work.