照顧一位肺炎併發急性呼吸衰竭病人成功脫離呼吸器之護理經驗

A Nursing Experience of Weaning the Ventilator for a Patient with Acute Respiratory Failure Secondary to Pneumonia

本文係筆者照顧一位因肺炎疾病引起急性呼吸衰竭個案之護理經驗，護理期間自2007年11月12日至12月6日，運用Gordon十一項健康功能型態進行護理評估及藉由會談、觀察、身體評估等方式收集資料，發現個案的健康問題有：呼吸道清除功能失效、呼吸器戒斷反應功能失常及睡眠型態紊亂等三個護理問題。在護理過程中除運用專業知識及技能外，並以同理心與個案建立良好的治療性人際關係，透過主動關懷、傾聽、鼓勵與家屬的支持、安慰，增加個案的自信心，克服疾病所帶來的衝擊，依據個案的健康問題給予個別性的護理，使個案在住院過程中獲得身、心、社會各方面的適應，並在醫療團隊的努力下能計畫性的脫離呼吸器。

This article described the author's experience of caring for a patient with acute respiratory failure secondary to pneumonia. The data were collected via interview, observation, and physical assessment during the period of nursing care from November 12 to December 6, 2007. With the tool of Gordon's 11 Health Function Appraisal, the following three nursing problems were diagnosed: failure to eliminate respiratory secretion, failure to respond to the ventilator weaning , and sleep disorder. With the family's support and comfort to the patient, utilization of professional knowledge and skill, development of good therapeutic relationship with empathy, and attention and encouragement, the author enhanced the patient's confidence in overcoming the impact of the disease. Individualized care was provided based on the identified nursing needs. The patient not only adapted to the disease in both physical and psycho-social aspects, but also successfully weaned the ventilator in the collaboration with the health care team.