協助一位心臟瓣膜置換術患者脫離呼吸器的護理經驗

本篇係描述一位罹患主動脈瓣膜逆流及狹窄併發心臟衰竭行瓣膜置換術之病患，面臨無法脫離呼吸器導致身心困擾之護理經驗。護理期間（94年4月15日－5月30日）筆者於加護單位藉由直接照護、筆談、觀察等方式收集資料，依Gordon十一項功能性健康型態進行評估，發現個案主要護理問題為1.呼吸器戒斷反應功能失常；2.焦慮；3.潛在危險性感染。在呼吸器脫離過程中，與個案建立良好護病關係，藉由整體照護概念，以傾聽、陪伴、同理心感受，提供雙向溝通、重覆解釋及個別護理措施，適時給予正向鼓勵，減輕個案的焦慮，終於遏止不安全感，成功脫離呼吸器並提升生活品質。

關鍵字

心臟瓣膜置換術；呼吸器脫離

並列摘要

This article describes the nursing experience when treating an aortic regurgitation combined with heart failure patient admitted for aortic prosthetic valve replacement.During 45 days of ICU care, weaning from ventilatory. The primary nurse used clinical observation, written with a pen and physical assessment guided by the Gordon 11-item Functional Health Pattern to identify the patient’s three major problems. These were dysfunctional ventilatory weaning response, anxiety, and risk for infection. The author used the specified nursing interventions to relieve the patient’s physiological discomfort related to post-aortic prosthetic valve replacement and to ventilatory weaning response and provided full information to ease the anxiety. This rare experience is a very good example to share with other nursing colleagues.