- 期刊
照顧一位巴拉刈中毒病患之護理經驗
The Nursing Experience of Caring a Patient with Paraquat Poisoning
摘要
巴拉刈在所有農藥中毒個案中，死亡率是最高的，其中以自殺者多，誤食者少，目前仍無有效的治療方法，只能盡量降低毒物吸收、促使毒物排出、減少對組織的傷害及不適狀況，以提高存活率。本篇個案報告為敘述一位巴拉刈中毒病患於收住加護病房期間之護理經驗，照護自97/6/8至97/6/17，以Gordon十一項健康功能型態來進行護理評估，確立問題有：（一）潛在危險性損傷／1.與中毒後可能導致器官損傷有關；2.與血液灌洗可能併發出血、低血容性休克有關；（二）口腔黏膜障礙／與口腔黏膜組織傷害導致吞嚥疼痛有關；（三）焦慮／1.與感受到健康狀態改變有關；2.與單獨處於加護病房環境中有關。針對病患之健康問題，筆者除提供鼻胃管灌洗、大量輸液、血液灌洗等治療的護理措施外，同時給予口腔護理緩解因口腔潰瘍所引起的疼痛不適，進一步注意避免發生出血、低血容性休克、感染等合併症，且對因健康改變引發之焦慮，提供其疾病資訊及心理支持以減輕其焦慮情形，期藉由照護經驗提供護理人員日後在照護此類個案之參考。
並列摘要
The death rate of paraquat is the highest among all the poisoning cases due to pesticide. Most of the cases were suicides and just few people took it by accident. There is still no effective cure for paraquat poisoning up to now. However, the living rate can be elevated by lowering absorption of poisonous substances, enhancing discharge of poisonous substances, and reducing tissues injury. This case report illustrates the nursing experience of caring a patient with paraquat poisoning in an intensive care unit. The care period was from June 8, 2008 to June 17, 2008. The nursing assessment was based on Gordon 11-item Functional Health Pattern and the nursing diagnosis involved (1) risk for injury/1. organs injury possibly caused by poisoning; 2. bleeding and hypovolemia shock possibly caused by hemoperfusion; (2) impaired oral mucous membrane/swallow pain caused by oral mucous membrane tissues injury; (3)anxiety/1. perceiving change of the health status; 2. being alone in an intensive care unit. In order to solve the patient's health problems, the researcher provided the related nursing interventions for nasogastric tube irrigation, massive infusion and hemoperfusion. In the meantime, the care for the oral cavity was provided to soothe discomfort caused by the oral cavity ulcer. Besides, the further prevention of bleeding, hypovolemia shock, infection and the other complications might induced by the medical treatments mentioned above should be strictly done. On the other hand, the disease information and psychological support were promptly provided to reduce the patient's anxiety caused by change of the health status. Through this nursing experience, the researcher hopes to assist the nursing staff in caring the patients with paraquat poisoning in the future.
延伸閱讀
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