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運用肺部復健運動協助一位老年流感重症病人呼吸器脫離之護理經驗

Applying Pulmonary Rehabilitation to Assist an Elderly with Serious Influenza Complications Undergoing Weaning from Mechanical Ventilation

Abstracts


本文描述一位老年個案因流感引發呼吸窘迫置放體外循環維生系統,擔心呼吸器脫離成效不佳需執行氣切手術,導致個案焦慮之加護經驗。護理期間自2018年9月12日~26日,藉由照護觀察、身體評估、筆談、病歷查閱等方式收集資料,運用生理、心理、社會及靈性四大層面進行整體性評估,確立護理問題為低效性呼吸型態、潛在危險性感染、焦慮。透過肺部復健運動讓個案感受到肌力的進步,進而降低焦慮對脫離呼吸器有信心。最終成功脫離呼吸器並順利轉出加護病房。期藉此照護經驗讓護理師應用於臨床重症個案,提升照護品質。

Parallel abstracts


This article describes an elderly with serious influenza complications experiencing acute respiratory failure and receiving extracorporeal membrane oxygenation. The uncertainty during waning from mechanical ventilation and fear of receiving tracheostomy resulted in the patient anxiety. Data were collected via observation, physical examination, interviews, and medical records between 12 September and 26 September 2018. We found the patient's health problems included ineffective breath pattern, risk of infection, and anxiety. Pulmonary rehabilitation was applied to enhance respiratory and to reduce anxiety assisting the patient with weaning from mechanical ventilator. Finally, the weaning was successful and the patient was transferred out of the ICU. This case report is hoped to provide health professionals with as a reference when caring such patients in order to improve care quality.

References


Prado, P. R. D., Bettencourt, A. R. D. C., & Lopes, J. D. L. (2019). Related factors of the nursing diagnosis ineffective breathing pattern in an intensive care unit. Revista Latino-americana De Enfermagem, 27, e3153. https://doi.org/10.1590/1518-8345.902.3153
王甯祺(2017)‧新興傳染病流行趨勢‧台北市醫師公會會刊,61(12),52-54。
吳方瑜、黃翠媛、陳玉娟(2018)‧老化的生理變化與護理‧於林麗嬋總校閱,老年護理學(八版,45-47 頁)‧華杏。
吳梅嵐、盧延洲、梁雅婷、蔡東霖、葉信住、黃俊立、賴柏伸、歐陽志佩(2019)‧體外循環維生系統在流感併發急性呼吸窘迫症候群之運用‧北市醫學雜誌,16(1),60-66。
李秋香、張淑華、王素美、賴慶祥、賴美玉(2015)‧音樂介入對使用呼吸器患者之焦慮成效探討-前驅性研究‧澄清醫護管理雜誌,11(1),31-38。

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