一位靜脈藥癮者感染心內膜炎之護理經驗

The Nursing Experience of Caring an Intravenous Drug Addict with Infective Endocarditis

蔡雅婷(Ya-Ting Cai) ； 趙麗玫(Li-Mei Zhao) ； 曾瓊誼(Chun-Yi Tseng)

《若瑟醫護雜誌》 12卷1期 (2018/10) Pp. 111-123

摘要

本文描述一位靜脈藥癮者因長期共用針頭導致感染心內膜炎，並誘發生理、心理相關健康問題之護理經驗。照顧期間自2015年6月日1日至6月24日，藉由直接照護、病歷查閱等方式進行資料收集，並運用Gordon十一項健康功能評估，加以分析整理，確認個案有：「體溫過高」、「營養少於身體所需」、「活動無耐力」、「焦慮」等健康問題。照顧期間個案除了規則抗生素治療外，針對感染的持續發燒，透過護理衛教，幫助個案解決身體不適狀況，偕同營養師調配個別飲食計畫，使個案能攝取足夠熱量對抗病魔。藉由教導個案深呼吸技巧並採漸進式運動，增加活動耐力程度，會診中醫師教導個案正確按壓穴道，達到放鬆進而減緩焦慮，並用多陪伴引導抒發內心擔憂感受，透過美沙酮個管師介入衛教，強化戒毒的決心。由於個案普遍年輕且疾病嚴重度高，以致影響身心症狀，故期望透過實際的護理經驗，讓護理人員面對照護藥癮者感染心內膜炎時，可發揮更具個別性之照護。

關鍵字

心內膜炎 ； 靜脈藥癮者 ； 焦慮

並列摘要

This paper illustrates the nursing experience of caring a patient with intravenous drug addict who has been exposed to endocarditis for prolonged sharing of needles and which induces physical and psychological health problems. The data was collected through clinical care and review of medical records since June 1 to 24 in 2015. After data analysis, the nurse assessed the patient with Gordon 11 Functional Health Status Assessments tool to establish patient experienced hyperthermia, inadequate nutrition intake, poor endurance to activities, and anxiety. During the nursing process, regular antibiotic was given, we also help the patient to release the discomfort, and persisting fever. Nutrition programs with diet was used to the patient to fight against the disease. Through our education, by taking deep breath and gradual exercises they could have better endurance of activity. The attending Chinese physician taught them how to correctly press the acupressure points to relax and relieve their anxiety. With more accompanying guidance, they told us their feeling more frequently. Through the involvement of methadone managers in education, we enforce the drug abuser to quit drug abuse. As the cases are generally young and the disease is so severe that they affect their physical and psychological symptoms. Therefore, we hope that nurses become more sophisticated in the treatment of endocarditis when taking care of drug addicts through practical nursing experience.

並列關鍵字

endocarditis ； intravenous drug addiction ； anxiety

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