- 期刊
一位慢性阻塞性肺疾病患者反覆發作之急診護理經驗
An Emergency Nurse's Experience of Caring for a COPD Patient with Recurrent Exacerbation
摘要
本文旨在描述一位81歲男性病人，多次因慢性阻塞性肺疾病急性發作導致呼吸困難至急診求治之護理經驗。急診護理期間為2013年6月18日至6月22日，運用觀察、會談、身體評估及病歷查閱方式收集資料，使用Gordon十一項功能性健康型態進行整體性之護理評估，確立個案之主要的健康問題為低效性呼吸型態、活動無耐力及知識缺失。藉由正確呼吸訓練方式，改善個案之通氣狀態及維持足夠的氧合，並且安排漸進式運動訓練增加個案之身體活動耐力，以及衛教指導加強個案對疾病的認知及照護技巧，終使個案病情改善順利出院。並於個案門診返診目前後電話關懷追蹤，個案皆能配合定時返診，長達6個月未再因急性發作重返急診，冀望此護理經驗能提供護理同仁照顧此類個案之參考。
並列摘要
This article describes an emergency nurse's experience of caring for an 81-year-old patient suffering from respiratory distress from recurrent exacerbation due to chronic occlusive pulmonary disease (COPD). The nursing period was from June 18 to June 22, 2013. Gordon's 11 Functional Health Patterns Assessment was used as a tool for comprehensive nursing assessment. The data were collected through observation, interview, physical examination and review of medical records. The identified major healthcare problems were ineffective breathing pattern, low activity intolerance and insufficient knowledge. The patient's ventilation status was improved with sufficient oxygenation through correct breathing training. With progressive exercise training, the patient's tolerance for physical activities increased. Patient education enhanced the patient's knowledge about the disease and self-care skills. The patient was discharged with an improved medical condition. Telephone followed-ups after patient discharge continued and the patient could return for clinic appointments as scheduled. The patient did not revisit the emergency department for acute exacerbation for over six months. The author expects that this nursing experience can be shared with other nurses taking care of patients with similar conditions.