一位年輕女性因流感重症使用體外膜氧合器之照護經驗

Nursing Experience of an Extra-Corporeal Membrane Oxygenation-Treated Patient by Severe Complicated Influenza: A Case Report

蕭淑娟(Shu-chuan Hsiao) ； 陳淑雅(Shu-ya Chen) ； 王妍惠(Yen-hui Wang)

《高雄護理雜誌》 37卷3期 (2020/12) Pp. 121-132

https://doi.org/10.6692/KJN.202012_37(3).0011

摘要

本文為照顧一位年輕女性，因流感重症合併急性呼吸窘迫症候群於加護病房使用體外膜氧合器維生之護理經驗。期間自2018年11月26日至12月9日，運用Gordon十一項健康型態為評估工具，透過會談、觀察、身體評估及傾聽技巧等方式收集資料，整理分析後確立個案有氣體交換障礙、無效性保護能力、焦慮等護理問題。於照護過程持續觀察並維持個案生命徵象穩定、與醫療團隊進行整合性合作，協助執行呼吸訓練，並提供潛在危險性出血的預防，使得個案改善氣體交換功能障礙問題，順利拔除氣管內管及體外膜氧合器；於心理上提供音樂及肌肉放鬆之技巧，正向鼓勵個案表達心裡感受、增強自信心，協助個案參與治療計畫，進而緩解焦慮問題，期盼此篇護理經驗能提供加護單位照顧流感重症患者之參考。

關鍵字

流感重症 ； 急性呼吸窘迫症候群 ； 體外膜氧合器

並列摘要

The article shares nursing experience of a young woman who presented with acute respiratory distress syndrome caused by severe complicated influenza and the use of extracorporeal membrane oxygenation (ECMO). From November 26^(th) to December 9^(th) in 2018, the author collected information via interview, observation, physical assessment and listening techniques. 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 impairment of gas exchange, potential risk of bleeding and anxiety. During the caring process, we kept observing and maintaining her vital signs as stable as possible, as well as integrating and cooperating with our medical members in order to help execute the training of respiration and prevent the possibility of potential bleeding. Finally, the patient’s gas exchange improved and her endotracheal tube and ECMO were removed successfully. Besides, interventions of music and muscle relaxation were provided, and the patient was encouraged to express her feelings to strengthen her confidence, she was encouraged to participate in the plan of treatment to relieve her anxiety. It is expected that sharing this care experience with nursing colleagues will assist in further preparation to facilitate holistic care for such patients of severe complicated influenza.

並列關鍵字

severe complicated influenza ； acute respiratory distress syndrome ； extracorporeal membrane oxygenation

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