一位因蛀牙引發放線桿菌屬感染細菌性心內膜炎病人之護理經驗

細菌性心內膜炎，不只會造成心臟與全身性器官產生急性的病徵，立即危害生命；亦有可能會造成慢性病變，遺留殘障。本文探討一位因蛀牙引發放線桿菌屬感染引發細菌性心內膜炎病人，在第一次住院便面臨疾病威脅及可能開心手術，所經歷的護理問題。筆者於2007年7月19日至2007年9月1日護理期間，運用Gordon十一項功能性健康型態評估工具，以會談、觀察等方式，收集主、客觀資料，加以分析整理；確認個案有：體溫過高、營養狀況改變、健康維護能力改變及害怕護理問題。筆者亦針對個案擬定個別性護理計畫，並給予個案、家屬支持與鼓勵，建立信心，協助個案與家屬面對疾病與可能手術的焦慮，渡過長期抗生素治療之過程，最後順利進入康復階段。由於臨床上因放線桿菌屬感染心膜炎之臨床照護案例不多，故將此護理經驗分享，提供護理人員日後照護此類病人之參考。

關鍵字

蛀牙；放線桿菌屬；護理經驗

並列摘要

Bacterial endocarditis not only causes acute systemic symptoms that may be immediately life-threatening, but it may also may lead to damage resulting in chronic disability. It is therefore not surprising that this condition engenders anxiety. After undergoing dental treatment for caries, a 30-year-old man developed endocarditis caused by Actinobacillus actinomycetemcomitans, an organism in the HACEK group of pathogens. The patient, who had never been hospitalized before, was extremely anxious. The author used Gordon's 11-item functional assessment and found the client's problems to include fever, poor nutrition, fear, and an inability to cope with the stress of his illness. The nursing addressed these issues and the patient was able to relax and cooperate with his medical care, leading to eventual recovery. Although infective endocarditis caused by of the HACEK organisms is rarely encountered in clinical nursing, this case illustrates that principles of good nursing care are applicable regardless of the etiology of the disease.

並列關鍵字

caries ； HACEK group ； caring experience

國際替代計量

一位因蛀牙引發放線桿菌屬感染細菌性心內膜炎病人之護理經驗

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