幼童哮吼合併退行性行為之急診護理經驗

The Nursing Experience of a Toddler with Croup and Withdrawal Behavior in an Emergency Room

莊惠娥(Hui-O Chuang) ； 郭嘉琪(Chia-Chi Kuo) ； 莊玉仙(Yu-Hsien Chuang)

《高雄護理雜誌》 29卷2期 (2012/08) Pp. 49-58

https://doi.org/10.6692/KJN-2012-29-2-5

摘要

本文旨在敘述照顧一位2歲哮吼病童之急診護理經驗。照護期間為2008年9月27日08：10至9月29日10：30止，筆者運用生理評估、發展評估及家庭評估為主要評估架構，再藉由身體檢查、會談、觀察、查閱病歷等技巧收集資料，發現病童的主要健康問題為低效性呼吸型態、體溫過高、退行性行為，藉由直接照護、示範指導及治療性遊戲的方式，陸續解決個案的生、心理問題。照護過程中更體會到文獻所提抗拒、哭鬧等退行性行為會加重哮吼的嚴重性，應用治療性遊戲可改善病童的退行性行為，繼而增進治療遵從性及避免哮吼症狀加重，僅藉此分享以提供臨床照護之參考。

關鍵字

哮吼 ； 退行性行為 ； 治療性遊戲

並列摘要

This report describes the caring experience of a 2-year-old child with croup in an emergency room. The period was from 08:10 on September 27(superscript th) to 10:30 on September 29(superscript th) in 2008. The author assessed the child's condition with respect to the child's physical, development and family assessment. Furthermore, the author also applied the skills of physical examination, interview, direct observation, and chart reviewing to collect data. The results indicated that the health problems of the child included ineffective breathing pattern, hyperthermia, and withdrawal behavior. Through direct care, demonstrative, guidance and therapeutic play, physiological and psychological problems of the patient were solved. Throughout the process of care, we gained better understanding of the withdrawal behavior like resisting or crying, which aggravated the severity of croup. Therapeutic play could improve the withdrawal behavior of the child, increase the compliance to treatment, and avoid exacerbation of croup symptoms. Therefore, we would like to share the nursing care experience so as to provide further reference for clinical care.

並列關鍵字

Croup ； withdrawal behavior ； therapeutic play