照顧一位境外感染惡性瘧疾急性期併發肺水腫病人之加護經驗

本文描述一位20歲男性大學生因境外感染惡性瘧疾急性期併發肺水腫在加護病房之護理經驗。護理期間2018年8月17日至9月4日，筆者運用Gordon十一項功能性健康型態評估，藉由觀察、身體評估、結構及非結構性會談等方式進行資料收集，確立病人有氣體交換功能障礙、現存性感染、焦慮之健康問題。護理過程中結合跨領域團隊進行合作討論，經水分控制、血液透析及呼吸器使用改善肺水腫急性期對氧氣的需求；提供感染症狀的醫護處置，協助病人杜絕瘧原蟲感染的惡化；透過家庭與宗教的支持及關懷，增加對抗疾病的信心以緩解病人的焦慮，順利解決病人各項健康問題；建議國內成立瘧疾疾病之支持團體，透過相互支持與鼓勵，經驗交流增進壓力因應處理，提升其生活品質，重回正常生活。

關鍵字

境外感染；惡性瘧疾；肺水腫

並列摘要

This article describes the nursing experience of a 20-year-old male college student who stayed in the intensive care unit due to an imported falciparum malaria infection with pulmonary edema in the acute stage. During the nursing period, Gordon's 11 functional health assessments were used to collect data through observations, physical assessments, and structural and nonstructural interviews. The data pertained to gas exchange dysfunction, existing infections, and anxiety related to health. A multidisciplinary teamwork approach to nursing was implemented to achieve the following goals: improve the oxygen demand in the acute phase of pulmonary edema through fluid control, hemodialysis, and the use of ventilators; help prevent the deterioration of falciparum malaria infection by providing medical treatment for infection symptoms; increase the patient's confidence in their ability to fight diseases to alleviate their concerns; and smoothly resolve the patients related health problems through the provision of familial and religious care and support. We propose that malaria disease support groups should be established to combine mutual support and encouragement with the exchange of experiences for improving patients' stress responses and quality of life and facilitating their return to normal life.