- 期刊
協助一位慢性阻塞性肺疾病人於氣切術後脫離呼吸器之照護經驗
Nursing Experience of a Chronic Obstructive Pulmonary Disease Patient with Tracheostomy Successfully Weaned from Ventilator
摘要
本文旨在探討一位因慢性阻塞性肺疾病引發呼吸衰竭男性患者，因反覆插管後決定接受氣管切開術並接受脫離呼吸器之護理經驗；護理期間為2019年11月9日至2019年12月3日，筆者透過觀察、會談、傾聽、身體檢查和病歷查閱等方式收集資料，並以Gordon十一項健康功能型態進行評估，確立病人主要護理問題有呼吸器脫離反應功能失常、照顧者角色緊張及健康管理失常等；運用同理心、關心和尊重的態度，與病人及其家屬建立良好治療性人際關係和信任感，透過醫師、呼吸治療師、營養師、物理治療師、語言治療師跨團隊共同照護，運用發聲閥，與病人及其家屬共同討論醫療計劃，藉由滿足病人生理需求、採取漸進式呼吸訓練、復健運動及吞嚥訓練，提供資訊協助病人維護自我健康、協助主要照顧者掌握各項照護知能，讓病人得以順利脫離呼吸器轉至普通病房。期望此照護經驗之分享，提供護理同仁日後照護之參考。
並列摘要
This article describes a male patient who suffered from COPD and respiratory failure and was successfully weaned from a ventilator after tracheostomy. The caring period was from November 9, 2019 to December 3, 2019. By Gordon 11 Function Health Patterns as the assessment guide the author used observation, interview, listening, physical examination, and medical record review to collect relevant subjective and objective information. Nursing diagnoses of the patient were (1) Dysfunctional ventilator weaning response (2) Caregiver role strain (3) Ineffective health management. We used empathy, care and respect to establish therapeutic relationship and sense of trust with patients and their families, with the collaborative effort of the medical team, and used the speaking valve to discuss medical plans with patients and their families. By meeting the patient's physiological needs, adopting progressive breathing training, rehabilitation, and swallowing training, it provides information to help patient maintain their own health, and assist the main caregivers to master various care information. Finally, we helped the patient to be weaned from the ventilator and transfered to a general ward. The author suggests that this case report may be used for future references.