照顧一位流感重症個案呼吸器脫離之護理經驗

Nursing Experience of Caring a Severe Influenza Patient with Ventilator Detachment

何宜蓁(Yi-Chen Ho) ； 趙一靜(I-Ching Chao)

《領導護理》 21卷4期 (2020/12) Pp. 88-102

https://doi.org/10.29494/LN.202012_21(4).0007

摘要

本文描述於亞急性呼吸照護病房照顧一位中年男性罹患流感合併急性呼吸窘迫症候群，因肌無力困難脫離呼吸器而感到焦慮之護理經驗。照護期間為2019年3月12日至3月25日，筆者藉由觀察、身體評估、筆談、查閱病歷等方式收集相關資料，確立三個主要健康問題：低效性呼吸型態、身體活動功能障礙及焦慮之健康問題。每日予個案執行拍痰等措施協助痰液清除外，亦於建立護病關係後，邀請個案及家屬共同安排個別化的肺復健運動引導個案循序漸進地完成肺部及上肢運動訓練，並於達到復健目標後予正向回饋，適時傾聽心理感受，增加復健意願和自信心，提升復健成效進而脫離呼吸器。協助個案配合後續治療與護理活動計劃，使病情獲得改善，及早讓個案回歸獨立生活，期盼本文能成為日後相似個案照護之參考。

關鍵字

流感重症 ； 低效性呼吸型態 ； 身體活動功能障礙 ； 焦慮

並列摘要

This article describes the experience of caring for a middle-aged man suffered from influenza combined with Acute Respiratory Distress Syndrome (ARDS) in Respiratory Care Center (RCC). The nursing period covers from March 12^(th) to March 25^(th), 2019. Data collection through observation, physical examinations, written communication, medical chart review, and determined three major nursing issues include ineffective breathing pattern, physical activity intolerance, and anxiety. In addition to daily measures of sputum shooting to assist airway sputum clearance, the author also invited the patient and his family to arrange individualized lung rehabilitation exercises to guide the patient to complete the lung and upper limb training step by step after establishing a nursing relationship. After reaching the rehabilitation goal, providing positive feedback, listen to the patient's inner feelings at the right moment, increase the willingness and self-confidence of rehabilitation, and improve the effectiveness of rehabilitation to hence detach from the ventilator. Assisted the patient to cooperate with the follow-up treatments and nursing activity plans to improve the condition, and hence return to live independently as soon as possible. This article hopefully can be a caring reference for others with similar patients in the future.

並列關鍵字

severe complicated influenza ； ineffective breathing pattern ； physical activity intolerance ； anxiety

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