照顧一位冠狀動脈繞道手術多次戒斷呼吸器失敗病患之護理經驗

本篇報告係探討一位冠狀動脈繞道手術後個案於93.3.27至93.4.30經多次戒斷呼吸器失敗之後，導致其身心困擾之護理經驗。筆者於護理期間運用Gordon十一項功能性健康型態評估工具，以筆談、觀察、身體評估等技巧，收集資料加以整理分析後，歸納個案呈現主要護理問題為1.呼吸器戒斷反應功能失常，2.疲憊，3.潛在危險性感染，4.體液容積過量等護理問題，在此期間，筆者提供全人的照護，藉由傾聽、陪伴、關心、同理心以暸解個案的需求，終而成功的戒斷呼吸器，文中提出的臨床經驗，期望能作為心臟加護病房護理人員於日後照護類似個案的參考。

關鍵字

冠狀動脈繞道手術；脫離呼吸器；疲憊

並列摘要

The purpose of this report is to present the nursing experience of a patient with post coronary artery bypass graft surgery who had physical, and psychological distress after several times of failure of weaning ventilator (3/27/93 to 4/30/93). During the period of care, the author assessed the patient s condition used by the Gordon's functional health assessment guide. Data was collected by writing, observation, and physical examination. The main problems of case report are: 1.dysfunctional ventilatory weaning response. 2. fatigue. 3. risk for infection. 4. fluid volume excess. In this period we provide physical care, holistic care by listening, company, caring, and empathy to understand needs of patient. Finally, patient was successful in weaning ventilator. The nursing experience from this case report can help nurses who will take care of similar cases in the cardiac care unit.