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題名:一位肺炎併發急性呼吸窘迫症候群患者之照護經驗
書刊名:長庚護理
作者:江素維胡彩華蔡宜蓁洪淑文
作者(外文):Chiang, Su-weiHu, Tsai-huaTsai, Yi-tsengHung, Shu-wen
出版日期:2017
卷期:28:2=98
頁次:頁324-335
主題關鍵詞:肺炎急性呼吸窘迫症候群無力感PneumoniaAcute respiratory distress syndromeARDSPowerlessness
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:2
  • 點閱點閱:5
本文探討一位罹患肺炎引發急性呼吸窘迫症候群的老年女性,因使用呼吸輔助機導致身心不適,且難以預測病情變化致衍生無力感之照護經驗。護理期間為2014年9月28日至2014年10月24日,筆者以觀察、會談及身體評估等技巧收集資料,運用羅氏適應模式進行整體性系統評估,發現個案出現氣體交換障礙、呼吸道清除功能失效及無力感等健康問題。照護期間運用關懷陪伴建立良好治療性護病關係,運用氧氣治療及呼吸器以保持血氧穩定濃度及有效控制感染,改善氧氣供需不平衡狀態;教導有效咳嗽及姿位引流技巧,輔以機械式胸腔叩擊,以利病人清除呼吸道分泌物;協助病人適應疾病變化及增強信念,肯定自我存在價值,降低對疾病產生的無力感。建議醫護同仁需加強個案及主要照顧者肺炎防治及居家照護技能,使其身、心皆獲得適切性照護及降低肺炎感染風險,期望經此照護經驗分享,以供臨床實務參考之用。
This paper presents the experience of providing care to an older woman with acute respiratory distress syndrome (ARDS) caused by pneumonia. The patient experienced physical and psychological discomfort from ventilator use as well as powerlessness caused by unpredictable changes in her condition. The patient received care from September 28, 2014 to October 24, 2014. The author collected data by applying techniques such as observations, interviews, and physical assessment. Roy's adaptation model was employed to comprehensively and systematically assess the patient. The patient's health concerns included impaired gas exchange, ineffective airway clearance, and powerlessness. During her care, compassion and companionship were used to establish a beneficial therapeutic care relationship, oxygen therapy and ventilators were used to maintain the oxygen concentration, effective infection control was achieved, and oxygenation was improved. The patient was taught effective coughing and postural drainage techniques, assisted by mechanical chest percussion devices, to clear airway secretions. Finally, the patient was aided in adapting to changes in her condition, increasing her faith, affirming her value of existence, and reducing the powerlessness caused by her illness. We recommend the staff need to strengthen patients and primary caregivers for pneumonia prevention and home care skills.
期刊論文
1.游群翔、陳炯睿(20120200)。俯臥通氣與急性呼吸窘迫症候群。內科學誌,23(1),1-8。  延伸查詢new window
2.Blanch, L.、Murias, G.(2012)。Back to the bench: Inhaled iloprost and prone positioning in ARDS。Minerva Anestesiologica,78(9),979-981。  new window
3.Pierrakos, C.、Karanikolas, M.、Scolletta, S.、Karamouzos, V.、Velissaris, D.(2011)。Acute respiratory distress syndrome: Pathophysiology and therapeutic options。Journal of Clinical Medicine Research,4(1),7-16。  new window
4.林詩淳、蔡坤維、江瑞坤、范國聖(20080200)。老年人的肺炎預防及護理。志為護理,7(1),65-70。  延伸查詢new window
5.潘美媛、黃雯嵐(20111200)。一位腹膜透析個案面對無力感之護理經驗。志為護理,10(6),118-128。  延伸查詢new window
6.陳玉如、林晏如、翁敏雪、李靜怡(20100100)。臺灣呼吸器使用患者之心生理因子與呼吸器脫離之相關性。臺灣醫學,14(1),1-8。  延伸查詢new window
7.呂珮菁(20091000)。一位肺炎合併呼吸衰竭脫離呼吸器個案之護理經驗。澄清醫護管理雜誌,5(4),55-62。  延伸查詢new window
8.林玟秀(20130300)。照護一位呼吸窘迫症候群併發呼吸衰竭之護理經驗。新臺北護理期刊,15(1),123-132。  延伸查詢new window
9.吳仁光、惠群(2013)。護理之家肺炎的臨床特性。內科學誌,24(2),107-117。  延伸查詢new window
10.朱秋蓉、龍芳、蘇妙姿、蘇怡齡、楊式興(20120100)。一位急性呼吸窘迫症病人在呼吸器策略及俯臥後併發氣胸之探討。呼吸治療雜誌,11(1),11-24。  延伸查詢new window
11.張惠如、邱月秋、高本蓉、李玉秀(20091200)。提升病患成功脫離呼吸器之專案改善。長庚護理,20(4)=68,471-484。new window  延伸查詢new window
12.鄒志翔(20071200)。急性呼吸窘迫症候群呼吸治療之新進展。北市醫學雜誌,4(9附冊),919-925。  延伸查詢new window
13.賴惠玲、黃敏瑢、周晉伊(20141200)。一位急性呼吸窘迫症候群病患採俯臥治療的護理經驗。長庚護理,25(4)=88,480-490。new window  延伸查詢new window
14.鄭芳旻、賴思妤(20081200)。照顧一位肺炎併發急性呼吸衰竭病人成功脫離呼吸器之護理經驗。領導護理,9(2),63-72。  延伸查詢new window
15.Koh, Y.(2015)。Update in acute respiratory distress syndrome。Journal of Intensive Care,2(1),2-6。  new window
16.Frutos-Vivar, F.、Nin, N.、Esteban, A.(2006)。Epidemiology of acute lung injury and acute respiratory distress syndrome。Seminars Respiratory and Critical Care Medicine,27(4),327-336。  new window
17.雙毓廷、杞燕如、胡瑞桃(20110800)。一位肺炎併發呼吸衰竭脫離呼吸器個案之護理經驗。領導護理,12(2),58-71。  延伸查詢new window
18.Meaghan, M. T.(2005)。ARDS Diagnosis and Management。Dimensions of Critical Care Nursing,24(5),197-207。  new window
19.Simon, O.(2003)。Aspiration pneumonia and pneumonitis。Australian Presenter,26(1),14-17。  new window
20.Wheeler, A. P.、Beneard, G. R.(2007)。Acute lung injury and the acute respiratory distress syndrome: A clinical review。Lancet,369(9572),1553-1569。  new window
研究報告
1.衛生福利部統計處(2014)。民國102年死因統計年報。  延伸查詢new window
其他
1.蔡忠榮(2006)。ARDS急性呼吸窘迫症候群,http://www.kmuh.org.tw/www/kmcj/data/9505/8.htm。  延伸查詢new window
2.衛生福利部疾病管制署(2015)。侵襲性肺炎鏈球菌感染症--流行病學,http://www.cdc.gov.tw/professional/page.aspx?treeid=098f3bc4756f62cc&nowtreeid=29AEBFC4D4DDC371, 。  延伸查詢new window
3.World Health Organization(2013)。New plan to address pneumonia and diarrhoea could save 2 million children annually,http://www.who.int/mediacentre/news/releases/2013/pneumonia_diarrhoea_plan_20130412/en/。  new window
圖書論文
1.何昭中、莊苹(2014)。呼吸系統疾病病人的護理。最新實用內外科護理學。台北:永大。  延伸查詢new window
 
 
 
 
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