一位腦梗塞病患住院中二次中風後的護理過程

Nursing Procedure for a Cerebral Infarction Patient Who Had a Further Stroke During Hospitalization

本報告是探討一位因腦梗塞住院，住院期間又再次發生腦梗塞的個案。照護期間為93年9月13日至9月30日，治療過程中經筆者以Gordon十一項護理評估，發現個案有組織灌流量改變、保護能力改變、自我照顧能力缺失、哀傷功能失常等健康問題；藉由鼓勵個案和家屬參與疾病治療及了解病程的演變，並教導家屬如何協助個案日常生活照顧，讓個案可以增加自信心，勇敢面對未來的生活，達到最佳的生活適應。綜觀目前的大環境，護理人員常因時間及經驗的不足，且加護病房的住院時間有限，無法給予病人及家屬適當的心理支持及傾聽，故希望藉本文與大家分享經由急性期照顧，了解個案生理、心理需求予以適當的支持及轉介、以達完全的照護。（志為護理, 2008; 7:3, 102-110.）

This article illustrates the nursing management of an elderly patient with vascular dementia. The patient was admitted due to showing short-term memory impairment and bodily weakness. The authors applied the eleven functional health patterns as described by Marjory Gordon to evaluate the physiology, mental acuity, social nature and spirituality of the patient. During the nursing period, the patient was found to have problems with chronic confusion, the management of therapeutic drugs, a self-care deficit and ineffective family intervention. We combined a physical assessment tool, empathy and listening to build up a good interpersonal relationship in order to provide sufficient information to the patient and main caregiver. This allowed the creation of a case plan and resulted in the patient's problems being alleviated. (Tzu Chi Nursing Journal, 2008; 7:3, 102-110.)