- 期刊
一位肺炎併發呼吸衰竭成功脫離呼吸器病患之護理經驗
The nursing experience regarding weaning of ventilator in a patient with respiratory failure caused by pneumonia
摘要
本文探討一位肺炎併發呼吸衰竭病患成功脫離呼吸器之護理經驗，個案歷經多次失敗呼吸訓練的折磨，致使個案心中有著揮之不去的痛楚，在跨團隊整合照護和家屬的鼓勵下，克服個案心中的恐懼成功脫離呼吸器。護理期間自2016年11月7日至12月1日，運用Gordon十一項健康功能評估，以觀察、直接照護、肢體及筆談等方式收集資料，確立健康問題為呼吸機戒斷反應功能失常、睡眠型態紊亂及焦慮。照護期間教導個案呼吸咳嗽技巧，搭配高頻胸壁震盪機，改善呼吸道負荷症狀。採集中護理，加以改善睡眠環境，並教導放鬆技巧，增進個案的睡眠品質。針對呼吸訓練所引發的焦慮，首先與個案建立良好護病關係，鼓勵抒發內心感受，讓個案重新感受到正向的呼吸器脫離經驗，以增進自信心。期望藉此照護經驗，讓臨床護理人員的悉心照護，成為個案保有身心復原的希望。
並列摘要
This article is discussing about the successful nursing experience of a patient who was diagnosed with pneumonia and respiratory failure. The failures of undergoing the weaning from ventilator many times keep in the patient's mind and cannot be expelled. Under the integrated care with our nursing team and the encouragement of his family, he conquered his fear and weaned from the ventilator successfully at the end. During the nursing period from 2016 November 7th to December 1st, We used Gordon's functional health patterns to collect data by observing, primary care and communication with writing. Consequently, we identified his problems with ventilator withdrawal dysfunction, sleeping disorders and anxiety. In the process of nursing, the patient was taught effective coughing and breathing skills. The symptoms of respiratory tract were highly with the help of high frequency chest wall oscillatory ventilation. Improving the environment and some tips of relaxation make the sleeping quality getting better under the methods of Centralized Nursing. Aiming at the anxiety of weaning ventilator, we had established physician-patient relationship and encouraged the patient to express his insight feeling at first. Then, we built up the patient's confidence to make it easier for him to wean from ventilator. Last but not the least, we hope this experience of nursing care can help other clinical workers to understand the importance of patient's nursing care and become the hope of patient's not only physically but also mentally.
延伸閱讀
- 陳美偵、陳淑卿、蔡佳憓（2014）。照顧一位慢性阻塞性肺疾病病人脫離呼吸器之護理經驗。若瑟醫護雜誌，8(1)，114-129。https://www.airitilibrary.com/Article/Detail?DocID=1819026x-201408-201409120005-201409120005-114-129
- 廖翊均、顏淑華（2022）。一位肺炎合併急性呼吸衰竭個案之照護經驗。源遠護理，16(3)，73-79。https://doi.org/10.6530/YYN.202211_16(3).0010
- 王毓鈴、陳秀鉛（2016）。一位慢性阻塞性肺疾病合併肺腺癌病患脫離呼吸器的護理經驗。新臺北護理期刊，18(1)，103-112。https://doi.org/10.6540/NTJN.2016.1.009
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- 黃美蕙、張聿仁、黃雅琳、莊芬蘭（2015）。Nursing Care Experience of Weaning Ventilator for a Postoperative Mediastinitis Patient with Respiration Failure。彰化護理，22(4)，43-56。https://doi.org/10.6647/CN.22.04.12