一位抗精神病藥物惡性症候群患者的護理經驗

Nursing a Patient with Neuroleptic Malignant Syndrome

本文主在呈現一位智能障礙患者因抗精神病藥物治療後，引發抗精神病藥物惡性症候群（neuroleptic malignant syndrome, NMS）的護理過程。在護理期間（92/7/18～92/7/24）筆者以漸進方式與病人建立信任關係，藉由戈登（Gordon）健康功能架構進行護理評估，確立個案四項護理問題，內容包括：「潛在危險性肺吸入」、「體溫過高」、「自我照顧能力缺失」、「潛在危險性皮膚完整受損」等四項。針對以上問題所在，將護理重點放在安全之維護，促進個案舒適與基本需求的滿足，減輕病患與家屬的焦慮，增加疾病認知，提升病患自我照顧的能力等方向。所幸病患於護理期間並無合併症產生，而護理目標亦能在計劃中順利達成，期望能藉此經驗的分享，增加同仁對NMS的認識，並提升專業的護理品質。

This article presents the nursing of a mentally retarded patient suffering from neuroleptic malignant syndrome (NMS) after administration of antipsychotic agents. The author gradually established a trusting relationship with the patient. Four major nursing problems were confirmed by means of nursing evaluation using Gordon’s functional health patterns including the terms 'potential risk of aspiration pneumonia', 'hyperthermia', 'lack of ability in self-care', 'potential risk of skin injury'. Resolution of the problems was focused on maintenance of safety, enhancement of comfort, satisfaction of basic needs, anxiety relief, promotion of self-care ability and family’s knowledge of the disease. Fortunately, no complications occurred during the nursing period. The nursing goals were achieved using the plan. We wish to share our experience and knowledge about NMS to improve nursing care.