- 期刊
照顧一位初次腦中風病患接受血栓溶解劑治療及處置併發症的護理經驗
The Nursing Experience of Caring for a Stroke Patient with Thrombolytic Therapy
摘要
本文描述一位78歲初次罹患缺血性腦中風的病息，使用血控溶解劑治療及產生併發症的照護經驗。筆者於加護病房以神經內科專科護理師的角色照顧此病息，照護期間於2011年10月13日至10月26日，經由詳細病史詢問、理學檢查及整體性的照護評估，發現個案主要的健康問題包含右側肢體乏力合併失語症、輕度腦水腫合併出血性轉化及吸入性肺炎，為避免其臨床症狀持續惡化，設定三大照護目標包含減少併發症產生、避免腦出血惡化、及控制感染。筆者在加護病房照護過程中透過對健康問題的分析、評估及處置，依三大目標給予病患積極的治療及照護，使併發症可以儘早獲得控制及改善，後續並與病患及家屬建立良好的互動關係，主動給予正向的支持及關懷，教導家屬正確的照護技巧，給予病患心理上的鼓勵，以增加復健治療的動力。希望藉此照護經驗的分享，期能提供相關護理人員在日後臨床照護之參考。
並列摘要
This article describes the nursing experience of caring for a 78-year-old stroke patient who suffered from complications secondary to thrombolytic therapy. As a neurological nurse practitioner, the author took care of this patient in the ICU from October 13 to 26, 2011. After conducting a detailed medical history review and an integrative physical examination and assessment, the author identified the following major health problems: right hemiparesis, aphasia, mild brain edema due to hemorrhagic transformation, and aspiration pneumonia. To prevent continuous clinical deterioration, the author established three care goals: reduction of complications, prevention of deterioration secondary to brain hemorrhage, and infection control. The author provided attentive care and treatment. Establishing a good therapeutic relationship with the patient and her family, the author offered positive support and patient education regarding the proper care techniques. The author encouraged the patient and enhanced his motivation for rehabilitation therapy. The author hopes that this article can serve as a clinical care reference for other nurses taking care of similar cases in the future.
延伸閱讀
- 楊雙鈺（2018）。照顧一位接受血栓溶解劑治療的急性缺血性腦中風病人之護理經驗。弘光學報，(82)，33-41。https://doi.org/10.6615/HAR.201809_(82).0005
- 鄭雅方、陳繪竹、刁綺慧（2014）。照護一位出血性腦中風病患之加護經驗。高雄護理雜誌，31(3)，87-98。https://doi.org/10.6692/KJN-2014-31-3-9
- 房怡慧、曾彥菁、盧美言（2016）。一位缺血性腦中風病人使用血栓溶解劑之急診照護經驗。領導護理，17(2)，58-69。https://doi.org/10.29494/LN.201606_17(2).0006
- 黃嘉琦、卓惠伶（2019）。一位急性缺血性腦中風病人接受溶栓治療之照護經驗。領導護理，20(1)，94-106。https://doi.org/10.29494/LN.201903_20(1).0007
- 陳麗紋、童蔘美、林月娥（2014）。The Nursing Experience of Caring for a Young Stroke Patient。志為護理-慈濟護理雜誌，13(6)，72-83。https://www.airitilibrary.com/Article/Detail?DocID=16831624-201412-201412300012-201412300012-72-83