照護一位主動脈剝離手術後患者呼吸器脫離困難之護理經驗

The Nursing Experience of a Difficult Ventilator Weaning Patient with Aortic Dissection Post Operation

本篇在於分享照護一位主動脈剝離手術後困難脫離呼吸器病人之照護經驗。護理期間自2011 年12 月09 日至2012 年01 月02 日。筆者於加護病房單位藉由觀察、會談方式收集主、客觀資料，分析歸納出個素有潛在危險性心臟及腦組織灌流減少/危險因素：心血管手術、焦慮、呼吸機戒斷反應功能失常等護理問題。針對上述的護理問題，經由筆談與肢體互動中，與之建立互信關係，提供個案對疾病處置相關之認知與健康尋求資源，進而改變健康行為等個別性的護理措施，並運用胸腔物理治療、呼吸器脫離訓練以及復健運動，達到有效促進個案健康之恢復與疾病調適。希望透過此次的整體性護理經驗分享，能提供日後醫護人員照顧類似病人之參考。This article describes the nursing care experience of a patient with aortic dissection disease post operation from December 2011 to January 2012. Data were collected through the interview and observation in the intensive care unit. The problems identified included risk for decreased cardiac and brain tissue perfusion, anxiety and dysfunctional ventilator weaning response nursing problems. Subsequently, we provided individualized nursing intervention, enhanced the medical treatment-related knowledge and changed the behavior. Supplying chest physiotherapy, ventilation weaning training, rehabilitation exercise, and health-seeking resources sought to promote the case health recovery effectively and adopt more healthy behavior. It is hoped that the holistic care experience could provide the medical teams reference for further clinic care.