照顧一位肺結核患者之護理經驗

Nursing Experience of a Patient with Pulmonary Tuberculosis

本文為探討一位肺結核患者因服用抗結核藥物出現副作用且又限制隔離於負壓病房產生焦慮之護理經驗。自2006年6月22日起至11月15日止，筆者運用Gordon十一項健康功能型態評估，以觀察、會談及身體評估等方式收集資料，確立三個主要護理問題為：不遵從行為、營養狀況改變與焦慮。針對其問題給予的護理重點包括：加強個案對肺結核之了解，如傳染途徑、藥物副作用等，經由不斷反覆的護理衛教及指導，增加個案之遵從性。提供及設計營養攝取，增加其免疫力、促進疾病康復。住院過程中，協助面對隔離所引發之焦慮，增加病房內設備與外界互動，同時建立良好護病關係，主動提供個案心理支持與鼓勵，最後讓個案能以正向心態面對疾病接受呼吸道隔離。

This article describes the nursing experience of taking care of the patient who suffered from the side effect of anti-tuberculosis medications and anxiety resulting from isolated treatment in the negative pressure ward. The author used the Gordon 11 functional health patterns and collected data by observation, interviewing, and physical examination from June 22, 2006 to November 15, 2006. Three main nursing problems were identified as non-compliance, altered nutritional status, and anxiety. According to these three problems, the priority of nursing included enforcing the patient’s understanding about pulmonary tuberculosis, such as the main pathway of infection, the side effects of medications, and enhancement the patient’s compliance by repeated health education and instruction. Besides, the patient was benefit from adequate nutrition intake, which improved immune function as well as general health status. We also relieved anxiety resulting from isolation by improving better communication between the ward and outside, providing better relationship between patients and care givers, and offering mental support. Finally, the patient was able to maintain a positive attitude toward being insolated.