照顧一位重症肌無力危象病人之加護經驗

The Nursing Experience of Caring for a Client with Myasthenia Crisis in the ICU

陳衍喬(Yen-Chiao Chen) ； 許家禎(Chia-Chen Hsu) ； 吳貞蓉(Chen-Jung Wu) ； 朱玉珊(Yu-Shan Chu)

《嘉基護理》 22卷2期 (2022/12) Pp. 58-67

摘要

本文描述照顧一位27歲女性因重症肌無力危象，呼吸器脫離困難及對疾病恢復感到茫然的加護護理經驗；筆者於2020年8月27日～9月7日以整體性評估為工具，發現個案有低效性呼吸型態、急性疼痛及無力感之健康問題；除提供急性期照護，如：給予維持氧合、教導肺復健運動及緩解疼痛措施外，並藉由陪伴關懷，引導個案說出內心感受、共同擬定肺復健計畫、鼓勵參與自我照護及增強其自信心，也協同家屬一起讓個案感受到被關愛，使其負向情緒轉為正向態度；期望藉此照護經驗分享，建議護理人員照護此類病人除著重急性期護理外，也需關注其心理及情緒狀態，協助以正向態度重建自我價值，使復原過程更順利。

關鍵字

重症肌無力 ； 低效性呼吸型態 ； 無力感

並列摘要

This article describes the care of a 27-year-old woman who is difficulty in ventilator weaning due to the myasthenia crisis, and feel at a loss of care for the recovery and future of the disease. The author used the holistic assessment as an assessment tool during the care process from August 27 to September 7, 2020, and found that the patient had health problems of ineffective breathing pattern, pain and powerlessness. In addition to providing acute care, such as maintain oxygenation and teach pulmonary rehabilitation exercises, and relieve pain measures, but also through active care, listen and guide patient to express the views of the sick and worry, jointly formulate pulmonary rehabilitation plans and gradually participate in self-care activities, and give encouragement to enhance self-confidence. In addition, We also work with their families to make the case feel loved and turn their negative emotions into positive attitudes. Therefore, it is hoped that by sharing this nursing experience, it is suggested that in addition to focusing on acute care, nurses in the ICU should also pay attention to assessing the patient's psychological state and emotions, so as to help rebuild self-worth with a positive attitude and make the recovery process smoother.

並列關鍵字

Myasthenia Gravis ； ineffective breathing pattern ； powerlessness

參考文獻

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