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題名:一位肺炎併急性呼吸衰竭個案之急診護理經驗
書刊名:長庚護理
作者:劉心瑋陳淑賢謝芳貴
作者(外文):Liu, Hsing-weiChen, Sue-hsienHsien, Fang-kuei
出版日期:2017
卷期:28:2=98
頁次:頁336-345
主題關鍵詞:呼吸衰竭呼吸道清除功能失效睡眠型態紊亂焦慮Respiratory failureIneffective airway clearanceDisturbed sleep patternAnxiety
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(1) 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:1
  • 共同引用共同引用:13
  • 點閱點閱:180
本文描述一位93歲男性罹患肺炎併急性呼吸衰竭,在面臨放置氣管內管覺得生命即將消失,考慮到氣管內管可能要長期留置,且致死亡時均無法脫離呼吸器甚至需終身臥床仰賴他人全責照顧。病人對未來無法預知結果,深度感覺生命受到嚴重威脅。2013年10月25日至10月27日的期間,筆者運用Gordon十一項功能性健康評估模式以直接會談、觀察、身體評估及病歷查閱進行評估,並且確立個案有呼吸道清除功能失效、睡眠型態紊亂及焦慮等健康問題,另外在住院期間,醫師運用半身人體模型及X光片向個案解釋病情進展及住院診療計畫與胸腔物理治療照護計畫,藉此改善與維持基本呼吸功能,並請家屬全程陪伴,提供支持、鼓勵個案筆述心中感受,進而降低焦慮,達成維持基本生理指標,順利脫離呼吸器之可能性,進而提昇個案對疾病治癒之信心。
This article described the nursing experience of caring a 93-year-old man having pneumonia complicated with acute respiratory failure. The patient felt that his life was likely to come to an end while experiencing endotracheal intubation. He strongly sensed that his life was threatened and felt scared due to the possible long-term use of the ventilator, which was something unable to be removed until his death, resulting in a permanent bedridden condition in need of total nursing care and an unknown future. During the nursing period from October 25 to 27 in 2013, the author evaluated the patient using Gordon 11 Function Health Patterns through direct meetings and conversations, observation, physical assessment, and reference to medical records for comprehensive health assessments. The results confirmed that the patient had several health problems, including ineffective airway clearance, sleep disorder, and anxiety. During his hospitalization period, an upper-half medical human model and X-ray films were utilized to explain his progress of health conditions, inpatient treatment planning, and the nursing plan of chest physical therapy. These plans were to improve and maintain the patient's basic respiratory functions. At the same time, his family was invited to stay with him during the whole process to offer support and encourage him to write down what he felt. By doing so, the author helped the patient to reduce anxiety, maintain normal physiological function, increase the possibility of successfully removing the ventilator and then further enhance the patient's confidence in recovery.
期刊論文
1.武香君、周汎澔(20081000)。音樂治療緩解呼吸器使用患者焦慮之心理及生理反應成效。護理雜誌,55(5),35-44。new window  延伸查詢new window
2.李佩蓉、葉惠玲(20101200)。照顧一位急性肺水腫放置氣管內管個案之護理經驗。志為護理,9(6),100-108。  延伸查詢new window
3.Feider, L. L.、Mitchell, P.(2009)。Validity and reliability of an oral care practice survey for the orally intubated adult critically ill patient。Nursing Research,58(5),374-377。  new window
4.Greyson, C. R.(2010)。The right ventricle and pulmonary circulation: Basic concepts。Revista Española de Cardiología,63(1),81-95。  new window
5.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
6.胡雅潔、徐雯娟(20130900)。一位上消化道腐蝕性潰瘍病患之護理經驗。長庚護理,24(3)=83,337-345。new window  延伸查詢new window
7.李怡樺、林琪馨(20130700)。運用芳香療法於口腔癌術後個案之護理經驗。澄清醫護管理雜誌,9(3),49-58。  延伸查詢new window
8.謝美惠、宋琇鈺、葉淑惠(20130600)。一位呼吸衰竭老人脫離呼吸器之護理經驗。秀傳醫學雜誌,12(1/2),37-47。  延伸查詢new window
9.張郁薇、潘麗鈴(20091200)。協助一位氣切造口併呼吸器使用病患之出院準備服務經驗。長庚護理,20(4)=68,530-539。new window  延伸查詢new window
10.許琦珍、張文慧、施榮恩(20080700)。重症病人睡眠品質改善專案。澄清醫護管理雜誌,4(3),47-53。  延伸查詢new window
11.Jiang, X.、He, G.(2012)。Effects of an uncertainty management intervention on uncertainty, anxiety, depression, and quality of life of chronic obstructive pulmonary disease outpatients。Research Nursing Health,35(4),409-418。  new window
12.Petrof, B. J.、Jaber, S.、Matecki, S.(2010)。Ventilator-induced diaphragmatic dysfunction。Current Opinion in Critical Care,16(1),19-25。  new window
13.Malkoc, M.、Karadibak, D.、Yildirim, Y.(2009)。The effect of physiotherapy on ventilatory dependency and the length of stay in an intensive care unit。International Journal of Rehabilitation Research,32(1),85-88。  new window
14.黃碧華、蕭雅莉(20080500)。一位心因性肺水腫併發呼吸衰竭患者脫離呼吸器之護理經驗。高雄護理雜誌,25(1),48-60。  延伸查詢new window
研究報告
1.行政院衛生福利部(2013)。2012生命統計主要死因統計。  延伸查詢new window
 
 
 
 
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