一位登革出血熱併發休克症候群患者之護理經驗

Nursing Experience of a Patient with Dengue Hemorrhagic Fever Induced Shock

本篇描寫一位感染登革熱而致休克併發多重器官衰竭患者之照護經驗。於97年4月23日至5月3日護理期間運用Roy's健康適應模式進行身、心、社會整合性評估，確立護理問題如下：因肺部肋膜積水而致自主性換氣障礙；血小板減少產生無效性保護能力；對病程急遽變化及入住隔離房而引發恐懼。藉由溝通、心理支持、肢體按摩、音樂、信仰等技巧，提供個案及家人身、心、靈支持；透過跨團隊會議確立治療方針，藉由升壓藥、輸血、洗腎、呼吸器及營養支持協助其渡過危險期。冀望藉此護理經驗對日後照護此類病患能有參考依據。

This report presented nursing experience of a patient with dengue fever-induced shock and multiple organ failure. During the nursing care period starting from April 23(superscript rd) to May 3(superscript rd), 2008, the author utilized Roy's adaptation model to assess the patient and identified three major health problems. These were impaired spontaneous ventilation, ineffective protection, and fear. The author applied psychological support, body massage, music, and religious support to improve the patient's and the family's physical, mental, and spiritual health. The patient's health problems could be identified in time through interdisciplinary case conferences. By using inotropic agents, blood transfusion, hemodialysis, ventilation, and nutrition support, the patient survived through this critical period. This case report can serve as a reference for future nurses who encounter similar nursing care situation.