照顧一位初次罹患自發性氣胸青少年之加護經驗

本篇個案報告是筆者照顧一位青少年初次罹患自發性氣胸的護理經驗，護理期間2017/10/25－10/28，藉由實際照護、觀察、會談的方式收集資料並進行身體評估，運用Gordon十一項功能性健康評估，將資料歸納分析出個案的主要健康問題有：一、低效性呼吸型態／與左側肺臟受壓致通氣量減少有關、二、急性疼痛／與胸管留置有關、三、焦慮／與初次罹患疾病不了解相關資訊有關。在照護期間筆者以鼓勵方式使其表達自我想法、了解其感受後制訂符合個別性護理措施、運用同理心、傾聽、主動關懷及陪伴等技巧，建立良好護病關係，提供個案一般胸管照護外，並以網路影片來做疾病相關衛教：如Triflow使用、利用個案喜歡五月天音樂及討論手機遊戲轉移對疼痛注意力，並利用同儕力量給予鼓勵與支持克服疾病所帶來的衝擊與焦慮。期望藉由此護理經驗，提供護理同仁照護類似個案之參考，提升照護品質。

關鍵字

自發性氣胸；青少年；加護病房

並列摘要

This article is about a nursing experience from looking after a primitive spontaneous pneumothorax adolescent. The nursing period was from October 25^(th) to 28^(th), 2017. According to Gordon's 11 functional health patterns assessment tool and the patient's physical assessment, the patient's main health issues were identified as ＂low functional respiratory pattern＂ related to decreased ventilation caused by left lung compression; ＂acute pain＂ related to chest tube indwelling; and ＂anxiety＂ related to not aware of relevant information when suffering from the disease for the first time. During the care period, the author encourages the patient to express his thoughts, after understanding his feelings, formulates particular nursing measures. Apply empathy, listening, active care, and companionship to establish a good nurse and patient relationship. In addition to the general chest tube care in this case, the author also uses online videos for disease-related health education such as Trifolw training, Use the patient's favorite music band - Mayday and discuss mobile games to divert attention from pain and make use of peer influence to encourage and support to overcome the impact and anxiety caused by the disease. It is hoped that this nursing experience can serve as a reference for nursing colleagues to take care of similar cases and improve the quality of care in the future.

並列關鍵字

spontaneous pneumothorax ； adolescents ； intensive care unit

參考文獻

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照顧一位初次罹患自發性氣胸青少年之加護經驗

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