巴拉刈中毒之急診護理經驗

Nursing Care for a Patient with Paraquat Intoxication in Emergency Room

陳穎瑜(Ying-Yu Chen) ； 葉怡伶(Yi-Ling Yeh) ； 蔡佳樺(Chia-Hwa Tsai)

《北市醫學雜誌》 5卷6_S期 (2008/12) Pp. 775-783

https://doi.org/10.6200/TCMJ.2008.5.6.22

摘要

本篇報告係描述一位男性個案，服用巴拉刈自殺，而導致低效性呼吸型態、急性疼痛、焦慮等三項主要問題。運用Gordon十一項健康功能型態為評估架構，經由直接照顧、身體評估、觀察、會談、等方式收集資料，結果發現個案有：（一）低效性呼吸型態與服用巴拉刈導致肺水腫、肺纖維化引發呼吸急促有關；（二）急性疼痛與服用巴拉刈導致口腔黏膜灼傷有關；（三）焦慮與巴拉刈中毒引發呼吸急促及口腔黏膜灼傷疼痛有關等健康問題。經由立即插入氣管內管併呼吸器使用；提供Demerol 50mg及2%Xylocaine漱口水使用，建立靜脈輸液及禁食；並予心理支持等護理措施，但因個案肺纖維嚴重，終究造成死亡，同時轉介社工師對案妻進行心靈關懷及輔導。

關鍵字

巴拉刈中毒 ； 低效性呼吸型態 ； 急性疼痛 ； 焦慮

並列摘要

The purpose of this report is to describe the nursing experience of taking care of a 54-year-old male patient who was suffering the effects of myocardial infarction. The nursing period was from June 21 to June 28, 2006. We used the 11 items of Gordon's Functional Health Pattern Model as an assessment framework and collected the related data through direct care, physical assessment, observation and by interviewing the patient. The results show that the patient had several nursing concerns including impaired cardiopulmonary perfusion, acute pain and anxiety. Oxygen was administered to the patient and vasodilators, a diuretic and morphine were also given. The patient was put into a more comfortable lying position, instructed on ways to alleviate pain, encouraged to express the source of his anxiety, provided with a more thorough knowledge of myocardial infarction and taught relaxation skills. As a result the patient's SpO2 rose from 85% to 95%, which made his pulmonary edema improve. According to a pain evaluation chart, the patient's score dropped from 8 to 3 and the patient said that his chest pain had also improved. Meanwhile, after providing him with hygiene education, the patient's degree of anxiety was alleviated.

並列關鍵字

myocardial infarction ； impaired systemic perfusion OR impaired cardiopulmonary perfusion ； pulmonary edema ； anxiety