- 期刊
一位多發性硬化症病人成功脫離呼吸器護理經驗
Nursing Experience of a Multiple Sclerosis Patient Successfully Weaned from Mechanical Ventilation
摘要
本文主要描述一位因多發性硬化症併發呼吸衰竭病人脫離呼吸器的護理經驗。護理期間自2018年09月13日至10月5日，運用Gordon十一項進行功能性健康評估，藉由會談、觀察、病歷查閱、收集病史及直接護理等方式收集資料，歸納出主要護理問題為呼吸道清除功能失效、身體活動功能障礙及焦慮。筆者在照護期間與病人建立護病關係，擬定胸腔復健運動計劃，教導病人有效咳嗽技巧及呼吸運動，透過強化呼吸肌改善病人呼吸功能，進而成功脫離呼吸器；教導家屬協助四肢肢體運動，及透過復健協助病人執行全關節主動及被動運動，提升病人四肢肌力，改善病人身體活動功能障礙問題；傾聽並引導病人表達內心感受，找出病人焦慮來源，並協助澄清病人的焦慮，降低對疾病的不確定感，促使病人正視疾病存在事實。建議建構相關疾病數位軟體系統，運用QR CODE即時掃描獲得疾病照護等相關衛教資訊，讓病人及家屬在住院期間及返家後也能即時掌握資訊，並且透過數位內容指導能持續執行居家復健運動，改善肢體失能進展，維持與疾病共存。
並列摘要
This article mainly describes the nursing experience of a patient with multiple sclerosis complicated by respiratory failure who was successfully weaned from mechanical ventilation. The nursing period was from September 13, 2018 to October 5, 2018, and according to the Gordon 11 item Functional Assessment of Health, data was collected through methods such as physical assessment, medical record review, post-operative care, observation and interviews. The nursing diagnosis was classified as: ineffective airway clearance, impaired physical mobility, anxiety. The author established a nursing relationship with the patient during the care period, developed a chest rehabilitation exercise plan, and taught the patient effective cough skills and breathing exercises in order to strengthen the breathing muscles and improve the patient's breathing function to, then successfully escape from the respirator, while family members were also taught to assist in limb movements. Implementation of the Rehabilitation Plan assisted the patient with active and passive joint movements, improved the overall muscle strength, and improved the physical activity dysfunction while the nursing practitioner listened and guided the patient to express their inner feelings, helped determine the source of anxiety, and clarified the patient's anxiety and knowledge about the uncertainty and existence of the disease. It is recommended that a digital software system be constructed for related diseases, and a QR CODE be used to scan information in real time so that patients and family members could also grasp the information in real time after returning home, and then continuing to perform home rehabilitation exercises through the digital information, thereby slowing the progress of limb disability and maintaining coexistence with the disease.
參考文獻
延伸閱讀
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