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題名 | 一位多發性硬化症個案之加護護理經驗=Caring for a Multiple Sclerosis patient in Intensive Care Unit |
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作者姓名(中文) | 廖宜邡; 楊秋菊; | 書刊名 | 源遠護理 |
卷期 | 4:1 2010.05[民99.05] |
頁次 | 頁78-87 |
關鍵詞 | 多發性硬化症; 調適障礙; 加護護理; Multiple sclerosis; Maladjustment; Intensive care; |
語文 | 中文(Chinese) |
中文摘要 | 本文是敘述一位因多發性硬化症導致意識改變、全身無力、呼吸喘個案之加護護理經驗。護理期間自2008年4月7日至4月21日,經由直接照護、觀察、會談收集病史,運用生、心理、靈性、社會層面評估,發現個案有低效性呼吸型態、身體活動功能障礙、皮膚完整性受損及調適障礙等護理問題。護理過程中適當的氧氣及胸腔物理治療,終使個案呼吸、血液動力學正常,改善呼吸問題;急性期執行被動性關節運動,急性期後示教漸進式的主動性關節復健運動,進而使肌肉關節無攣縮僵硬、雙手肌力達到5分;定時的翻身擺位及傷口敷料更換,使得壓瘡經擴創後傷口癒合良好且無新的壓瘡產生;護病關係的建立、心理支持及教導減壓方法來面對調適障礙,使其有信心因應及調適再次的發病過程,勇敢面對未來。照護多發性硬化症個案,應訂定整體性計畫及措施,藉由護理措施的介入,使其能達到身、心、靈的平衡,正向面對重新的生活。希望藉此次護理經驗提供護理同仁日後照護此類個案之參考。 |
英文摘要 | This article describes the nursing of a patient diagnosed with multiple sclerosis who experienced a change in level of consciousness, general weakness, and shortness of breath in an intensive care unit. The patient’s nursing problems included ineffective breath pattern, impaired mobility, impaired skin integrity,and maladjustment. Shortness of breath and hemodynamic improved after appropriate oxygen therapy and chest physiotherapy. Passive joint movement and progressive active joint rehabilitation helped to reduce the contracture of limbs and to recover strengths of both hands to full strength gradually. Pressure ulcer care included regular position change and meticulous wound dressing change. Establishment of a therapeutic relationship provided the psychological support and promoted the acceptance of patient education. It also helped the patient’s adaptation to illness and potential recurrence. In order to provide a holistic care to help patients achieve balanced body, mind and spirit of patients diagnosed with multiple sclerosis, it is important to make an integral treatment plan and interventions. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。