Objective To construct a volume management program based on Information-Knowledge-Attitude-Practice（IKAP） theory and to discuss its application effect for patients with heart failure in vulnerable phase. Methods The 4 process and capacity management architecture based on IKAP theory were constructed by the expert group discussion method. Using the convenience sampling method,94 patients with heart failure from May to October 2021 were selected as the experimental group,and the same number of patients from May to October 2020 were selected as the control group,both of whom were admitted to a tertiary first-class hospital in the city of Nanchang. The experimental group received the volume management program based on IKAP theory,and the control group received the routine care of the department. Finally,we evaluated the effect of the intervention. Results 94 patients in the experimental group and 92 patients in the control group were finally collected. There were statistically significant differences in self-care ability,weight management ability,B-type natriuretic peptide level,dry body mass compliance rate and readmission rate between 2 groups after the intervention（P<0.05）. Conclusion The volume management program based on IKAP theory can improve self-care ability,weight management ability and dry body mass compliance rate of vulnerable patients with heart failure,and reduce B-type natriuretic peptide level and readmission rate in vulnerable phase.

Objective To investigate the relationship between the changes of blood pressure and palmar swelling during radial artery compression in patients with radial artery percutaneous coronary intervention (PCI). Methods The patients who underwent radial artery PCI in the coronary heart disease unit of a tertiary general hospital in Nanchang from May 2018 to December 2020 were selected as the study subjects. The general data and the related indexes of decompression were analyzed retrospectively,and the blood pressure fluctuation during radial artery compression was described. Univariate regression analysis was used to analyze the influencing factors of palmar swelling on the operative side,and the blood pressure during radial artery compression was divided into nodes. The effects of different blood pressure on operative side palm swelling were analyzed by stratification,and the corresponding range of blood pressure at the highest risk of operation side palm swelling was further analyzed by trend regression. Results A total of 788 patients with radial artery PCI were included. Based on the analysis of patients’ baseline data,it was found that history of diabetes,history of hypertension,signs of heart failure and high average systolic blood pressure during radial artery compression were the risk factors of operative palmar swelling. However,multivariate stratified analysis of risk factors showed that systolic blood pressure ≥130 mmHg during radial artery compression increased the risk of ipsilateral palm swelling in patients with diabetic history (OR=1.09,P<0.001). In patients with or without heart failure signs and hypertension history,when the systolic blood pressure during radial artery compression was more than 130 mmHg,the 2 groups increased the risk of palmar swelling on the operative side. Furthermore,trend regression analysis showed that the average systolic blood pressure during radial artery compression was between 130 and 149 mmHg. Every 10 mmHg increase in systolic blood pressure had increased the risk of palmar swelling by 3.52 times[95%CI (1.37,13.22) ]. Conclusion During the period of radial artery compression,the average systolic blood pressure of patients is 130-149 mmHg,and the risk of palmar swelling on the operative side is the highest. It is suggested that clinical nurses should comprehensively consider the changes of systolic blood pressure when formulating the prevention plan for complications of palmar swelling on the operative side.