一位甲狀腺毒性週期性麻痹症併嚴重低血鉀病人之急診護理經驗

An Emergency Nursing Experience of a Patient with Thyrotoxic Periodic Paralysis and Severe Hypokalemia

陳琳雅(Lin-Ya Chen) ； 李盈瑩(Ying-Ying Li) ； 倪玉齡(Yu-Ling Ni) ； 王玉真(Yu-Jen Wang)

《長庚護理》 35卷3期 (2024/09) Pp. 83-92

https://doi.org/10.6386/CGN.202409_35(3).0008

摘要

本文是描述一位甲狀腺毒性週期性麻痹症併嚴重低血鉀病人之急診護理經驗。護理期間為2020年8月11日18:30至22:00，運用Gordon十一項功能性健康型態，以觀察、會談與理學檢查收集資料，確立電解質失衡、潛在危險性跌倒及焦慮之護理問題。在心電圖監控下，使用靜脈輸液滴注氯化鉀，以安全地提升病人的血清鉀濃度及改善肢體肌肉的癱軟無力；使用跌倒危險評估工具確認病人的跌倒風險，並提供預防跌倒的照護措施；運用肌肉放鬆技巧、音樂療法及分享成功案例以緩解其焦慮情緒。期望此護理經驗可作為日後照護類似病人之參考。

關鍵字

甲狀腺毒性週期性麻痹症 ； 低血鉀 ； 焦慮

並列摘要

This article describes the emergency nursing experience of a patient with thyrotoxic periodic paralysis and severe hypokalemia. The care was provided from 18:00 to 22:30 on August 11, 2020. Gordon's eleven functional health patterns were used to collect data through observations, interviews, and physical examinations. The primary nursing problems identified included electrolyte imbalance, risk for falls, and anxiety. Potassium chloride was diluted in normal saline and administered via intravenous infusion, accompanied by continuous electrocardiogram monitoring, to safely increase serum potassium levels and improve muscular weakness in all four extremities. The fall risk assessment tool was utilized to evaluate the patient's fall risk, and appropriate nursing interventions were implemented for fall prevention. Additionally, interventions such as meditation, muscle relaxation techniques, music therapy, and sharing successful case stories were employed to alleviate the patient's anxiety. This nursing experience can serve as a valuable reference for healthcare professionals caring for similar patients in the future.

並列關鍵字

thyrotoxic periodic paralysis ； hypokalemia ； anxiety

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