- 期刊
一位急性呼吸窘迫症候群合併肌肉無力患者之加護經驗
Nursing Experience in a Case with Acute Respiratory Distress Syndrome and Muscle Weakness
摘要
本文描述一位肺炎進展為急性呼吸窘迫症候群患者，因使用呼吸器、制動及鎮靜藥物治療引發肌肉無力，因擔憂未來自我照顧能力問題而有焦慮情形之照護經驗。護理期間為2018年12月4日至12月25日，筆者藉由身體評估、直接護理、觀察、會談及病歷查閱方式收集資料，進行生理、心理、社會及靈性層面之整體性評估，確立個案有氣體交換障礙、身體活動功能障礙、焦慮等健康問題。護理過程中首重穩定生命徵象及維持氧合狀態，待個案病況改善後及早介入復健措施，增強其肌肉力量以提升身體活動功能；運用同理心並提供個別性的關懷、照護、支持與鼓勵，建立良好護病關係，減輕個案焦慮的程度。在跨領域醫療團隊的努力之下，個案成功脫離呼吸器後，轉至胸腔內科病房接受後續的治療與照護。期望經此照護經驗分享，提供護理人員未來照護此類患者臨床實務之參考。
並列摘要
This article aims to describe a patient with acute respiratory distress syndrome caused by pneumonia. The patient was very anxious and worried about the muscle weakness induced by using mechanical ventilation, immobilization and sedative medications that might affect self-care ability in the future. During the period of nursing from 4th December to 25th December, 2018, for completing systematic assessment of physical, psychological, social and spiritual aspects of health issues, the author collected the data from various aspects including the physical assessments, clinical nursing care, observations, interviews and medical clinical records. The major nursing problems included gas exchange impairment, impaired physical mobility and anxiety disorders. Firstly, prone ventilation was adopted to maintain the patient’s vital signs and oxygenation in the stable status and secondly, a rehabilitation program for the patient was arranged to improve the symptoms of muscle weakness and physical mobility as soon as possible when the patient's condition would get better. For establishing a good nurse-patient relationship and decreasing the anxiety disorders, individualized nursing care, support and encouragement with empathy was provided. Under multidisciplinary teamwork, the patient was extubated successfully and transferred to the chest medical department to receive further treatments and nursing care. The authors wish to share this case report to nursing professionals as a reference.
參考文獻
延伸閱讀
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