照顧一位年輕型橋腦缺血性梗塞病人之護理經驗

Nursing Experience of Caring for a Young Patient With Pontine Stroke

許巧燕(Chiao-Yen Hsu) ； 周美香(Mei-Hsiang Chou)

《榮總護理》 40卷1期 (2023/03) Pp. 96-102

https://doi.org/10.6142/VGHN.202303_40(1).0011

摘要

本文描述照護一位43歲男性橋腦缺血性梗塞病人之護理經驗。護理期間為2021年3月31日至4月29日，藉由觀察、會談、身體檢查與評估等方法收集資料，運用Gordon十一項健康功能型態評估分析，確立健康問題為吞嚥障礙、身體活動功能障礙、自我照顧能力缺失及焦慮。藉吞嚥訓練、漸進式調整飲食質地，改善吞嚥障礙並移除鼻胃管；因肢體無力，透過復健、教導輔具使用，進而可用輪椅及助行器輔助移位，獨立完成大部分日常生活功能，改善身體活動功能障礙及自我照顧能力缺失問題；病人因初患腦中風感到焦慮，運用關懷、同理心及傾聽，提供腦中風照護知識與技巧，改善焦慮情緒，偕同語言治療師及復健治療師等跨團隊提供照護，希望藉照護經驗，提供臨床上照護此類病人應更重視身心理問題，給予周全性照護。

關鍵字

年輕型中風 ； 吞嚥障礙 ； 身體活動功能障礙

並列摘要

This article describes our nursing experience of caring for a 43-year-old patient with pontine stroke. The nursing period was from March 31, 2021, to April 29, 2021. Using the 11 functional health patterns proposed by Gordon, relevant data were collected through observation, conversation, and physical examination. The patient had various health problems, such as dysphagia, impaired physical mobility, self-care deficit, and anxiety. First, dysphagia was improved through swallowing exercises and the use of thickening agents; subsequently, the nasogastric tube inserted for feeding was removed. Second, limb weakness was alleviated through rehabilitation and the use of assistive devices to help the patient independently perform most physical activities of daily living and improve their physical mobility and self-care ability. Finally, anxiety and depression were reduced through empathic listening. In addition, we taught the patient self-care knowledge and techniques. Physical and speech therapies were also incorporated to provide holistic care. Our experience may serve as a reference for nurses providing comprehensive physical and mental care to patients with ischemic stroke.

並列關鍵字

young stroke ； dysphagia ； impaired physical mobility

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