協助一位Guillain-Barre'症候群孕婦成功脫離呼吸器之護理經驗

The Nursing Experience of SuccessfuI Weaning for a Pregnant Woman with Guillain-Barre' Syndrome

本篇主旨為協助一位於懷孕期間罹患Guillain-Barre'症候群之個案成功脫離呼吸器之護理經驗。筆者於2009年11月9日至12月15日護理期間，運用Gordon十一項功能性健康評估系統為評估架構，以實際照護、觀察、手勢、筆談溝通及查閱病歷等方式收集資料，發現個案的健康問題包括：呼吸器戒斷反應功能失常、身體活動功能障礙及焦慮。在護理照護期間，因個案的家庭支持系統不足，除主動聯繫社工人員介入外，更藉由筆談、適當陪伴及同理心與個案建立治療性人際關係，鼓勵其表達內心感受並給予心理支持，以減輕焦慮感；經由醫療團隊的合作，提供與疾病相關的資訊，安排計畫性的肢體復健及胸腔復健運動，使個案成功脫離呼吸器轉至普通病房。期望藉由此照護經驗與護理同仁分享，提供日後照護此類個案之參考。The aim of this case report is to discuss a pregnant woman who suffered from acute Guillain-Barre' Syndrome was successfully weaned from the ventilator. The nursing period was from November 9 to December 15, 2009. Data was collected by primary care, observation, interview and chart review. The eleven Gordon's Functional Health Patterns were applied for systemic evaluation. Three nursing problems were indentified, including dysfunctional ventilator weaning response, impaired physical mobility, and anxiety. During the nursing process, the social worker was introduced to the patient because of poor family support. Using conversation by writing, accompany and empathy to establish therapeutic relationships with the case, encourage the expression of feelings and give psychological support to reduce the anxiety. Through the medical team to provide disease-related information, arrange physical rehabilitation and pulmonary rehabilitation programs, the case was successfully weaned from the mechanical ventilator and transferred to the general wards. We hope this nursing experience can serve as a reference for future nurses.