一位流感重症病人使用葉克膜之加護經驗

Nursing Experience of Caring for a Foreign Worker with Influenza on ECMO

呂燕靜(Yen-Ching Lu) ； 賴芊孝(Chien-Hsiao Lai)

《領導護理》 19卷2期 (2018/06) Pp. 51-62

https://doi.org/10.29494/LN.201806_19(2).0005

摘要

本文爲罹患流感重症，合併急性呼吸窘迫症於加護中心接受體外循環維生系統支持且併發合併症之加護經驗。護理期間爲2016年3月10日至5月5日，運用Gordon十一項功能性健康型態評估，透過觀察、實際參與照護及溝通，確立個案有：一、氣體交換障礙/與流感重症併急性呼吸窘迫症候群有關；二、保護能力改變-出血/與使用體外循環維生系統有關；三、家庭因應能力失調-危害性/與面對個案疾病威脅產生恐懼有關。運用多次醫護共同討論方式，主動告知其個案疾病資訊、醫療處置及預後發展，協助後續的照護安置，讓家屬能用正向態度面對問題，減輕其負面情緒。期望能藉由經驗分享，提供給日後照護此類個案之參考。

關鍵字

流感重症 ； 體外循環維生系統 ； 急性呼吸窘迫症 ； 家庭因應能力失調

並列摘要

The article describes a nursing experience of caring for a foreign worker with influenza on ECMO. The nursing period was from March 10 to May 5, 2016. The case evaluation utilized Gordon's 11 functional health patterns assessment with data gathered through observations, interviews and physical assessments. The identified nursing problems were impaired gas exchange due to influenza with acute respiratory distress syndrome, lack of bodily protection in the case of potential bleeding due to ECMO, anxiety from the consequences of the illness in providing for family and a lack of knowledge of the disease. By way of discussion, the patient was informed about the disease, medical treatment and prognosis. Follow-up care after the treatment was created and a positive attitude was fostered in both the patient and their family to face the problems related to the disease. It is expected that this care experience will be used to provide an example to caregivers to caring for patients in similar situations.

並列關鍵字

Severe influenza ； extracorporeal membrane oxygenator ； acute respiratory distress syndrome ； coping with disease and familial responsibilities

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