- 期刊
一位呼吸衰竭之愛滋病病患的護理經驗
Nursing Experience of an AIDS Patient with Respiratory Failure
摘要
本文描述一位剛確診為愛滋病，就罹患肺部最常見的肺囊蟲肺炎合併症，引發呼吸衰竭插置氣管內管及胸管而入住加護病房之護理經驗，照護期間為2018年1月14日至1月25日。筆者透過直接照護、觀察、會談、身體評估、病歷查閱及追蹤探訪等方式收集資料，確立個案有低效性呼吸型態、不確定感及焦慮等健康問題。護理期間介入醫療照護團隊，清楚告知生命徵象及解釋病情，鼓勵個案針對改善肺功能的呼吸復健計畫提問。在舒緩低效性呼吸型態及降低不確定感後而成功拔管；筆者亦經由密集性探視、適時給予正向鼓勵建立護病關係，透過照護團隊合作，降低音量及減少吵雜環境干擾，並請家屬會客時給予精油按摩舒緩個案之焦慮，照會心理師協助個案與家屬溝通，順利向家人坦承罹患愛滋疾病及同志身份，將家人轉為支持愛滋病治療的助力，此個案之護理經驗，期能與重症護理同仁分享，作為臨床愛滋病患者照護之參考。
並列摘要
This article describes a person who had just been diagnosed with AIDS and had pneumocystis pneumonia, the most common complication of AIDS. This induced respiratory failure and admission to the ICU requiring intubation of the endotracheal tube and chest tube. The period of care was from January 14, 2018 to January 25, 2018, and Gordon's 11 health function assessment tool was used. Data was collected through primary care, observation, interviews, physical examination, medical record review and follow-up visits, etc. Health problems such as inefficient breathing pattern, uncertainty, and anxiety were established. During the nursing period, the medical care team informed the patient and family of specific vital signs and explanation of the condition, while encouraging them to raise questions for a respiratory rehabilitation training plan to improve pulmonary function. After relieving the inefficient breathing pattern and reducing uncertainty, successful extubation was performed. Through intensive visits, the author also gave positive encouragement in a timely, manner to establish a nursing relationship. The medical care team worked together to reduce noise in the ICU environment and asked family members to give the patient an essential oil massage to relieve anxiety. A psychologist was consulted to assist the patient in communicating with family members regarding AIDS and homosexuality, thereby reframing family member attitudes into giving positive support for AIDS treatment. The nursing experience of this patient could be shared with colleagues in intensive care and also used as a reference for the care of clinical AIDS patients.
參考文獻
延伸閱讀
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