運用肺部復健於脫離呼吸器病人之護理經驗

A Nursing Experience of Caring for a Ventilator-DependentPatient Receiving Pulmonary Rehabilitation

莊寒玉(Han-Yu Chuang) ； 馬瑞菊(Jui-Chu Ma) ； 林宜青(Yi-Ching Lin)

《領導護理》 12卷3期 (2011/12) Pp. 61-71

https://doi.org/10.29494/LN.201112.0008

摘要

本文以肺部復健介入措施協助病人脫離呼吸器。護理期間為97年9月5日至9月15日，筆者以Gordon十一項健康功能型態評估，以實際觀察、身體評估、手勢及紙筆溝通等方式蒐集資料分析歸納後，確立個案護理問題有：呼吸肌戒斷反應功能失常／與呼吸肌耐受力不足有關、營養狀況改變：少於身體需要／與食慾不振及脫離呼吸器的耗能有關、焦慮／與擔心氣管造成手術之疑慮及呼吸器脫離失敗有關。針對病人各項健康護理問題提供個別性的護理措施，制定適合病人的呼吸器脫離模式及肺部復健措施，提供合宜的營養支持，降低病人焦慮及生理上之不適，使病人終能順利脫離呼吸器轉至普通病房。期盼藉此臨床經驗分享，提供護理人員日後照護此類病人之參考。

關鍵字

肺部復健 ； 呼吸衰竭 ； 脫離呼吸器

並列摘要

This study describes a nursing experience in helping a ventilator-dependent patient wean off the machine via pulmonary rehabilitation. With Gordon's 11 functional health patterns' assessment, data were collected by means of observation, physical assessment, and communication through gesture and writing. Identified nursing problems included the dysfunction of ventilator weaning response associated with intolerance of respiratory muscles, altered nutrition secondary to poor appetite and energy consumption for machine weaning-off, and anxiety about failure of weaning-off the machine. Individualized nursing interventions based on the patient's nursing needs were setting the adequate ventilator mode for pulmonary rehabilitation, offering enough calorie count for patient intake, and reducing the patient's emotional anxiety and physical discomfort. The patient was able to be transferred out of the intensive care unit after the ventilator was successfully weaned off. The author shares this nursing experience with other health care providers caring for patients with ventilators as a care reference.

並列關鍵字

pulmonary rehabilitation ； respiratory failure ； weaning mechanical ventilation