照顧一位肺泡蛋白沉著症病人的護理經驗

本文描述一位中年男性因呼吸喘入院治療，確診為肺泡蛋白沉著症，需立即進行肺泡灌洗術以緩解不適症狀。護理期間為2018年1月9日至1月17日。筆者藉由身體評估、查閱病歷、觀察、傾聽及會談等方式收集資料，進行生理、心理、社會與靈性層面的整體性護理評估，確立個案有氣體交換障礙、活動無耐力、焦慮之健康問題。筆者於個案術前指導呼吸訓練，衛教省力活動，以緩解生理不適症狀，運用傾聽及關懷，鼓勵個案表達內心焦慮情緒；術後持續落實呼吸訓練與運動計畫；出院前衛教個案出院後疾病預防及定期返診等個別性護理，使病人能順利接受治療，緩解症狀與焦慮，在不需要使用氧氣的情況下步行出院。由於肺部功能障礙及罕見的肺泡灌洗術，易使病人感到生命威脅及焦慮，照護面首重呼吸道功能的維護，及早介入肺部復原訓練；其次則以病人為中心，減緩其焦慮，促使病人主動參與自我照顧及運動計畫，增進治療成效。期盼藉由此護理經驗，提供護理人員未來照護此疾病病人時，有更完整的照顧規劃與執行內容之參考，提升護理照護品質。

關鍵字

肺泡蛋白沉著症；肺泡灌洗術；焦慮

並列摘要

This article describes a middle-aged man admitted to the hospital for asthma and was diagnosed with alveolar proteinosis, who required immediate alveolar lavage to relieve discomfort. The nursing period is from January 9 to January 17, 2018. The author collects data through physical assessment, medical records research, observation, listening, and interviews; and conducts holistic nursing assessments in terms of physical, psychological, social, and spiritual aspects. Hence establishes the patient encounters health issues such as impaired gas exchange, activity intolerance, and anxiety. The author provides breathing training and teaches labor-saving activities before the operation to ease symptoms of physical discomfort, and offers listening and caring to encourage patient to express his anxiety. Postoperative breathing training and exercise plans are conducted continuously afterwards. Before discharge, individualized care education for the patient regarding disease prevention and the importance of returning to the clinic regularly, so the patient can receive treatment smoothly, relieve symptoms and anxiety, and hence was able to leave the hospital without respiratory support. Due to lung dysfunction and rare alveolar lavage, patients often feel life-threatening and anxious. The maintenance of respiratory function is the first priority in nursing care and early intervention in lung rehabilitation training. Secondly, focus is on the patients, try to reduce their anxiety, and encourage patients to actively participate in self-care and exercise programs in order to improve effectiveness of the treatment. It is hoped that from this nursing experience, nursing staff will have a more complete reference for care planning and implementation content when caring for patients with this type of disease in the future, to further improve the quality of nursing care.

並列關鍵字

alveolar proteinosis ； alveolar lavage ； anxiety

參考文獻

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