頁籤選單縮合
| 題 名 | 照顧一位主動脈剝離術後病人之加護護理經驗=Intensive Care Experience for a Patient Suffering from Acute Myocardial Infarction for the First Time |
|---|---|
| 作 者 | 李怡瑩; 林靖芸; | 書刊名 | 領導護理 |
| 卷 期 | 26:4 2025.12[民114.12] |
| 頁 次 | 頁37-52 |
| 分類號 | 419.821 |
| 關鍵詞 | 主動脈剝離; 低效性呼吸型態; 急性疼痛; 焦慮; Aortic dissection; Inefficient respiratory pattern; Acute pain; Anxiety; |
| 語 文 | 中文(Chinese) |
| DOI | 10.29494/LN.202512_26(4).0004 |
| 中文摘要 | 根據衛生福利部資料顯示,主動脈瘤及剝離死亡人數為968人/每十萬人口,死亡率4.2%。主動脈剝離是無預警且須立即手術,若未緊急治療,有極高的死亡率。本文探討一位青年男性因A型主動脈剝離接受緊急班特式手術(Bentall procedure)之加護經驗。個案因疼痛無法順利執行心肺復健,對於加護病房環境陌生及擔憂預後故引發筆者書寫動機。護理期間為2023年10月5日至10月9日。運用Gordon11項功能性健康型態評估,經由直接護理、身體評估、觀察、書面筆談、訪談進行資料收集,歸納分析個案有疼痛/與術後傷口有關,低效性呼吸型態/與移肺部擴張不全以及焦慮/與加護病房陌生環境及擔憂預後有關等三項健康問題。護理過程中提供偕同跨團隊共同照護、調整止痛藥物搭配非藥物類精油耳穴按摩緩解疼痛,擬定心臟復健治療計畫搭配有效深呼吸技巧促使肺部擴張;提供安靜舒適環境、治療前充分解說、鼓勵表達心中之感受,延長會客時間使親友與陪伴合併音樂聆聽,搭配圖文衛教手冊提供詳細解說衛教內容,建議加入病友會群組增強支持系統分享成功案例,降低個案焦慮。透過此案例分享提供護理人員照顧此類個案之參考,提高護理照護及恢復日常生活。 |
| 英文摘要 | According to Ministry of Health and Welfare statistics, the death toll from aortic aneurysms and dissections was 968 per 100,000 people, with a mortality rate of 4.2%. Aortic dissection triggers unexpectedly and requires immediate surgery. The mortality rate is extremely high without emergency treatment. This study discusses the experience of providing intensive care to a young man undertaken the Bentall procedure for a Type A Aortic Dissection. The author was inspired to commence this study due to cardiopulmonary rehabilitation failed as the patient was in extreme pain, unfamiliar with the intensive care unit environment, and was also distressed about his prognosis. Care was provided from October 5 to 9, 2023. An assessment framework based on Gordon's 11 Functional Health Assessment was applied, data was collected through direct nursing care, physical assessments, observations, written communication, and interviews. The patient's three major health issues were identified as postoperative wound pain, ineffective breathing patterns caused by atelectasis and anxiety, and unfamiliar with the intensive care unit environment as well as concerns about his prognosis. Interprofessional collaborative care was used in the nursing care process. For pain relief, the analgesic dosage was adjusted, and non-pharmacologic essential oils were used for auricular massage. For lung capacity improvement, a cardiopulmonary rehabilitation plan was devised to educate the patient about effective deep breathing techniques. Other measures included providing a quiet and comfortable environment, provide thorough explanation before treatment, encouraging the patient to express his feelings, extend visiting time to allow friends and family to accompany him collaborate with listening to music, arranging detailed health education through illustrated handbooks, and recommending the patient to join supporting groups among patients. This allowed him to share, listen to the successful experiences of others, and reduce his anxiety. The insights gained from this nursing experience serve as a reference for providing care to similar cases in the future, improving the quality of nursing care, and assisting patient resume daily routine. |
本系統中英文摘要資訊取自各篇刊載內容。