照護一位急性呼吸窘迫症候群病人之護理經驗

Nursing Experience Learnt from Caring a Patient with Acute Respiratory Distress Syndrome

林睿瑜(Jui-Yu Lin) ； 陳麗秋(Li-Chiu Chen)

《領導護理》 21卷3期 (2020/09) Pp. 50-59

https://doi.org/10.29494/LN.202009_21(3).0005

摘要

本文係探討一位急性呼吸窘迫症候群個案，於住院期間血氧低與心跳停止嚴重症狀，使用體外維生系統介入治療，在加護病房期間發現個案出現對治療產生無望感，而拒絕配合醫療處置，故筆者於2016年9月14日～2016年10月3日照護期間，藉由身體評估、點擊平板電腦方式進行溝通與會談並以觀察、直接護理等方法收集料，確立個案有氣體交換障礙、活動無耐力及無望感等三項健康問題。針對護理問題，運用跨領域團隊合作方式，設計符合個案護理措施，護理過程中運用關懷、傾聽及鼓勵，提供個案生理、心理、靈性全人照護，包含：透過醫護人員詳說治療目的與共同訂定護理目標，鼓勵表達對疾病感受，減少個案生理症狀及心理壓力，除此之外鼓勵父母積極共同參與治療，增強個案正向信心，亦期望藉此經驗分享，提供護理人員日後照護相關經驗。

關鍵字

急性呼吸窘迫症候群 ； 氣體交換障礙 ； 活動無耐力 ； 無望感

並列摘要

This article discusses the caring of a patient who suffered from acute respiratory distress syndrome (ARDS), resulting in oxygen desaturation and cardiac arrest. ECMO (extracorporeal membrane oxygenation) was applied for interventional treatment. During the intensive care period, the patient developed a sense of hopelessness, disappointment and refused to cooperate with medical treatment. From the period of 9/14/2016 to 10/03/2016, the author through physical assessment, and communicates via clicking on the tablet computer to collect data. It was established that the patient has three health issues including gas exchange disorder, lack of physical strength and endurance, as well as hopelessness towards recovery. In order to resolve these issues, the cross-disciplinary teamwork method was designed to meet the individual nursing measures. We provided body-and-mind holistic health care, including customized nursing process, encouraged her to express herself, and included her parents in our treatment plans in order to encourage patient's positive thinking. We hope through this report, our caring experience can be shared with other nursing colleagues when facing a similar situation in the future.

並列關鍵字

acute respiratory distress syndrome (ARDS) ； gas exchange impaired ； activity intolerance ； hopelessness

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