ICA Stenosis(내경동맥 협착) 우선순위 및 총괄적 소견, 간호진단 3개(만성통증, 불면증, 낙상위험성)

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1. ICA Stenosis(내경동맥 협착)

ICA Stenosis(내경동맥 협착)은 내경동맥이 좁아지는 질환으로, 혈류를 감소시키거나 혈관을 막아 허혈성 뇌졸중의 원인이 된다. 주요 증상으로는 두통, 어지러움, 오심 등이 있으며, 진단을 위해 뇌혈관조영술 등의 검사가 필요하다. 치료로는 약물 요법과 함께 스텐트 삽입술, 경동맥 내막 제거술 등의 수술적 치료가 있다. 간호 중재로는 통증 및 수면 관리, 낙상 예방 등이 중요하다.
2. 만성통증

환자는 7월부터 간헐적으로 발생하는 두통, 어지러움, 오심을 호소하고 있다. 입원 당시 NRS 5점의 두부 전체 통증을 호소하였고, 이후에도 NRS 4점으로 지속되는 양상이다. 만성 통증 관리를 위해 진통제 투여와 함께 통증 양상 및 강도에 대한 지속적인 사정이 필요하다.
3. 불면증

환자는 낯선 병원 환경으로 인해 밤낮으로 잠들기 어려워하며, 피로감을 호소하고 있다. 수면 방해 요인을 파악하고 수면 위생 교육, 수면진정제 투여 등의 중재가 필요하다.
4. 낙상 위험성

환자는 혈압강하제와 수면진정제 복용, 허약한 보행 능력 등으로 인해 낙상 위험이 높은 상태이다. 낙상 위험 사정 결과 고위험군으로 평가되었으므로, 침상 주변 환경 관리, 보조기구 사용, 낙상 예방 교육 등의 중재가 필요하다.

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1. ICA Stenosis(내경동맥 협착)

ICA stenosis, or internal carotid artery stenosis, is a serious medical condition that occurs when the main artery in the neck that supplies blood to the brain becomes narrowed or blocked. This can lead to a decreased blood flow to the brain, which can result in a stroke or other neurological complications. The primary cause of ICA stenosis is atherosclerosis, a buildup of plaque in the artery walls. This plaque can gradually accumulate over time, leading to a gradual narrowing of the artery. Risk factors for ICA stenosis include age, high blood pressure, high cholesterol, diabetes, smoking, and a family history of the condition. Symptoms of ICA stenosis can include dizziness, headaches, vision problems, and transient ischemic attacks (TIAs), which are temporary episodes of stroke-like symptoms. In severe cases, the stenosis can lead to a full-blown stroke, which can be devastating and potentially life-threatening. Early detection and treatment of ICA stenosis are crucial to prevent these serious complications. Diagnostic tests, such as carotid ultrasound, CT angiography, or MRI angiography, can help identify the extent of the stenosis. Treatment options may include lifestyle changes, medication, or surgical interventions, such as carotid endarterectomy or carotid artery stenting. It is important for individuals with risk factors for ICA stenosis to undergo regular screening and to work closely with their healthcare providers to manage the condition and reduce the risk of stroke. With proper treatment and monitoring, many people with ICA stenosis can maintain a good quality of life and avoid the devastating consequences of a stroke.
2. 만성통증

Chronic pain is a complex and debilitating condition that affects millions of people worldwide. It is defined as pain that persists for more than three months and can significantly impact an individual's quality of life, physical and emotional well-being, and overall functioning. The causes of chronic pain can be diverse, ranging from underlying medical conditions, such as arthritis, neuropathy, or fibromyalgia, to injuries or trauma. In some cases, the cause of the pain may not be easily identifiable, making it challenging to diagnose and treat effectively. Chronic pain can have a profound impact on an individual's daily life, leading to difficulties with physical activity, sleep disturbances, depression, anxiety, and social isolation. The emotional and psychological toll of living with chronic pain can be just as significant as the physical symptoms, and it is essential to address both aspects of the condition. Effective management of chronic pain often requires a multidisciplinary approach, involving a combination of pharmacological, non-pharmacological, and lifestyle interventions. This may include medications, physical therapy, cognitive-behavioral therapy, mindfulness-based techniques, and alternative therapies, such as acupuncture or massage. It is crucial for individuals with chronic pain to work closely with their healthcare providers to develop a comprehensive treatment plan that addresses their unique needs and goals. This may involve a trial-and-error process to find the most effective combination of therapies, as the response to treatment can vary from person to person. In addition to medical interventions, self-management strategies, such as pacing activities, practicing relaxation techniques, and engaging in regular exercise, can also play a significant role in managing chronic pain and improving overall well-being. Ultimately, the key to effectively managing chronic pain is a holistic, patient-centered approach that addresses the physical, emotional, and social aspects of the condition. With the right support and treatment, many individuals with chronic pain can learn to manage their symptoms, improve their quality of life, and regain a sense of control over their health and well-being.
3. 불면증

Insomnia is a common sleep disorder that affects millions of people worldwide. It is characterized by the persistent difficulty in falling asleep, staying asleep, or waking up too early and not being able to fall back asleep. Insomnia can have a significant impact on an individual's physical, mental, and emotional well-being. The causes of insomnia can be multifaceted, ranging from underlying medical conditions, such as chronic pain, anxiety, or depression, to lifestyle factors, such as stress, poor sleep hygiene, or irregular sleep-wake patterns. In some cases, insomnia may be a symptom of a more complex sleep disorder, such as