協助一位心肌炎個案成功脫離呼吸器之護理經驗

A Nursing Experience of Assisting a Patient with Myocarditis to Wean from the Ventilator

連美琪(Mei-Chi Lien) ； 李榮真(June-Chen Lee)

《安泰醫護雜誌》 20卷1期 (2014/06) Pp. 13-25

摘要

本篇個案報告是一位21歲男性過去反覆感冒長期服用成藥，兔疫力降低，導致心肌炎併發急性呼吸衰竭，困難脫離呼吸器而轉入呼吸照護中心。筆者於2010／10／2～25護理期間，籍由觀察、筆談、病歷來收集資料，及Gordon十一項健康功能型態評估，確立個案有言辭溝通障礙、中度呼吸機戒斷反應功能失常、照顧者角色緊張、營養狀況改變：少於身體所需、身體活動功能障礙等健康問題。在護理過程中筆者藉由建立治療性關係，教導個案以嘴形表達身體所需，並提供適當溝通工具，例如「基本需求圖卡」的使用，改善溝通能力；針對照顧者身心疲累及學習照護技巧時面臨的問題，提供適當的情緒支持與宣洩。並結合其他專業醫療團隊進行呼吸訓練，提供個別性的照護，發揮護理獨特的功能，讓護理專業服務品質更為提升。

關鍵字

心肌炎 ； 脫離呼吸器 ； 溝通

並列摘要

This case report represents a 21-year-old man with recurrent common colds and usage of long-term over-the-counter drugs, suffered from acute respiratory failure, complicated by myocarditis. Because of difficulty in weaning from mechanical ventilator, he was transferred to respiratory care center. From October 2nd to 25th 2010, by observation, interview , case history, and based on the Gordon's 11 functional health patterns, the author makes sure that the patient had the following health problems: nutrition, altered less than body requirements, communication, impaired verbal, ventilator weaning response dysfunctional, caregiver role strain. During the nursing course, the author established good therapeutic relationship with the patient by the following methods: educating the patients to express needs by reading his mouth, providing appropriate tools for communication, such as picture cards, offering fair emotional support system to release stress, and cooperating with other professional medical teams for respiratory muscle training and individual care to enhance the nursing quality.

並列關鍵字

Myocarditis ； Weaning from ventilator ； Communication