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| 題 名 | 跨團隊整合照護因腦出血併發神經性肺水腫個案之加護經驗=Interprofessional Collaborative Care Nursing Care of a Patient with Neurological Pulmonary Edema after Craniotomy |
|---|---|
| 作 者 | 莊富翔; 藺寶珍; | 書刊名 | 新臺北護理期刊 |
| 卷 期 | 27:1 2025.03[民114.03] |
| 頁 次 | 頁173-182 |
| 分類號 | 419.821 |
| 關鍵詞 | 顱內動脈瘤破裂; 神經性肺水腫; 俯臥; Intracranial aneurysm rupture; Neurogenic pulmonary edema; Prone positioning; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6540/NTJN.202503_27(1).0016 |
| 中文摘要 | 開顱手術後可能引起併發症,其中以神經性肺水腫最為嚴重,及時的醫護處置十分重要。本文描述一位因顱內動脈瘤破裂併發神經性肺水腫個案之加護照護經驗。護理期間自2021年12月11日至2022年1月4日,藉由身體評估、會談、醫護討論、病歷查閱方式收集資料,進行生、心、社會及靈性之整體性評估。確立其主要健康問題為:氣體交換障礙、顱內調適能力降低、照顧者角色緊張等。住院期間照會專科醫師、社工師、營養師及其家屬共同參與醫療決策,提供跨團隊整合性照護。急性照護除密切監測神經學及生命徵象變化,並針對神經性肺水腫此罕見併發症予以實證俯臥介入,改善氧合狀態;當案女面臨個案病況急遽改變造成的焦慮情緒予傾聽、鼓勵表達內心擔憂及適當提供資訊,最終個案順利脫離呼吸器並轉出加護病房。而本文受限於神經性肺水腫相關文獻及照護經驗甚少,建議未來臨床能增加個案討論會,並設立俯臥相關規範,使個案得到完整且全面性之照護,更可有效改善病情與提高護理品質。 |
| 英文摘要 | Among the complications of craniotomy, neurogenic pulmonary edema is the most serious, requiring timely treatment. This article describes the critical care nursing experience of a case with a rupture of intra-cranial aneurysm complicated with neurogenic pulmonary edema. The period of nursing care was from December 11th, 2021 to January 4th, 2022. Data were collected from physical assessment, observation, interview, and chart review to evaluate her physical, psychological, social, and spiritual health. Primary nursing problems included intracranial adaptation capacity, impaired gas exchange, and caregiver role strain. During hospitalization, specialist, nurses, social workers, and dieticians encouraged her family to make medical decisions in collaboration with the medical team. During acute care, in addition to closely monitoring changes in neurology and vital signs, prone positioning was performed to improve the oxygenation of a female patient who developed the rare neurogenic pulmonary edema. The patient, who experienced anxiety toward the procedure, was encouraged to expressed her concerns; medical practitioners listened to her attentively and provided thorough information. Consequently, the patient was successfully weaned from the ventilator and discharged from the intensive care unit. Relevant literature and experience on neurogenic pulmonary edema are lacking; therefore, clinical case conferences should be held with increased frequency and better guidelines for prone positioning should be established to provide better care for patients with neurogenic pulmonary edema and enhance the quality of nursing. |
本系統中英文摘要資訊取自各篇刊載內容。