本報告主要在探討一位法洛式四重症術後患者併發心臟衰竭之個案所面臨之問題。心臟衰竭患者因疾病需採用限鈉限水飲食，又因經常呼吸困難、疲倦感而更加影響其對治療飲食之進食慾望與水分控制尺度。具體飲食衛教方法及適當運動能提高病患營養、增加心肺功能及減輕疲倦感。護理期間自97.03.10至97.03.24。筆者運用主動關懷、觀察與會談方式收集資料，並依生理、心裡、社會及靈性四個面向進行護理評估，發現主要護理問題有體液容積過量、心輸出量減少、高危險性皮膚完整性受損等。依其原有疾病及現存問題擬訂個別性之飲食與心臟復健照護計畫，協助個案恢復穩定並期出院後能繼續自我照顧功能，提升生活品質。

The purpose of this report was to describe nursing experience with a 45-year-old female with heart failure and the tetralogy of Fallot status after total correction. Patients with heart failure often suffer from dyspnea and fatigue which lead to poor appetite and greater thirst. Good nutrition, a low-salt diet, water restriction, and physical exercise greatly benefit these patients. The nursing process was used to assist this patient from March 10 to 24, 2008. Data were collected through direct care, observations, and interviews. We found that the patient suffered from three main health problems: an excessive fluid volume, decreased cardiac output, and risk to skin integrity. Because of these health problems, we provided physiological and psychological nursing care to the patient, such as an exercise program for cardiac rehabilitation and instructions on how to prepare her daily food to maintain adequate nutrient intake and nutrition including a low-salt diet and water restriction. We expect the patient to be able to continue her activities and promote her self-care ability after discharge.