一位巴拉刈中毒病人的護理經驗

The Nursing Experience of Caring for a Paraquat Poisoning Patient

巴拉刈中毒者屬於急重症個案，且中毒後常出現器官進行性損傷，臨床上尚無有效的治療方法，因此儘早降低巴拉刈在體內吸收及促進排出方式以降低巴拉刈中毒的傷害與密切照顧，可提高此類病人存活率。本篇個案報告是在描述一位巴拉刈中毒病人於加護中心照護期間之護理經驗。護理期間為2008年4月15日至4月23日，運用Gordon十一項健康功能進行護理評估，確立個案的護理問題有：潛在危險性損傷、疼痛、體溫過高及害怕等四個問題。在急性期照顧過程中，除了降低巴拉刈所造成的傷害，維持個案生命徵象，避免發生低血容性休克、出血及呼吸急促等合併症，同時給予口腔護理以維持口腔舒適性，緩解個案因吞服巴拉刈引起口咽潰瘍疼痛的情形，並適度減輕因發燒引起的不適。亦藉由提供疾病相關資料及心理支持，來減輕個案因受到生命威脅所引發的害怕，以協助個案身心重建。藉此提出巴拉刈中毒存活個案之護理經驗，期能於專業領域中作經驗之分享。

The patients with paraquat poisoning belong to critical care cases. Poison from this agent often results in progressive organ failure and there are no effective treatments. We reduce damage from paraquat by quickly lowering the absorption and increasing the elimination rate. With careful monitoring, we may improve the survival rate of these patients. This case report described the nursing experience of caring a paraquat poisoning patient in Intensive Care Unit from April 15 to April 23 in 2008. The health problems were established according to Gordon 11-items functional health pattern, including risk for injury, pain, hyperthermia, and fear. The author supplied the appropriate nursing interventions as well as reduced the patient suffering from paraquat toxicity, maintained the vital signs, prevenedt the complications of hypovolemic shock, bleeding and breathlessness. The author assisted the mouth care in keeping oropharyngeal comfortable and relieving pain from oropharyngeal ulcer due to swallowing paraquat and reduced the discomforts of fever. The author also provided the patient with information about the disease and mental support to his fear of life threatening problems, and reconstructed the patient’s physical and psychological status.