肌無力危象是肌無力重症,病人雖意識清醒、但卻力不從心,因呼吸肌無力而引發呼吸衰竭,致使身心飽受折磨。本文描述一位34歲女性因肌無力危象入住加護病房之護理經驗;照護期間為2020年5月15日至5月22日,運用羅氏適應模式進行健康評估,以病歷查閱、身體評估、會談及直接照護等收集資料,確立病人有呼吸道清除功能失效、活動無耐力及焦慮等健康問題。護理期間以關懷、同理技巧與病人建立關係,密切監測生理狀態,執行漸進式復健運動,提升痰液自咳能力及肌耐力,成功移除呼吸器並回復自理能力,且運用音樂與芳療紓緩病人情緒,藉傾聽及陪伴過程協助病人逐步適應病程,降低對治療的不確定性及焦慮感。經照護發現,肌無力病人因自我監測能力不足導致危及生命,建議未來可參照衛生福利部罕見疾病照護服務計劃,以全程全人照護為理念,使用個案管理模式,有效運用各職類醫事人員、病友、社會資源等,提供病人及家屬個別性的照護措施,強化自我照護能力,即時回應每位病人與其家人的照護需求,並進行病情監測與積極管理。
This report describes the nursing experience associated with the application of Roy's adaptation model to the care of a patient with myasthenic crisis presented to the intensive care unit. The nursing period was from May 15, 2020, to May 22, 2020. Data collection was performed on the basis of medical record review, physical assessment, interview, and direct care. The patient's major health problems included ineffective airway clearance, activity intolerance, and anxiety. The nursing process involved assisting the patient in performing progressive rehabilitation exercises, improving cough power and muscular endurance, listening to music, undergoing aromatherapy, removing the respirator, reducing anxiety, and adapting to the disease course. In the future, whole-person care should be adopted, and case management should be performed for disease monitoring and active management.