照顧一位登革出血熱患者之護理經驗

An Experience Nursing a Patient with Dengue Hemorrhagic Fever

本篇個案報告是在描寫照顧一位單純出外散步遭受蚊蟲叮咬而成為登革出血熱患者的護理經驗。筆者於91年11月8日至91年11月15日間，藉由觀察、訪談及應用Gorden十一項功能性健康型態評估等技巧收集資料、確立問題。在護理過程中發現個案因感染登革熱病毒，生理上產生血小板減少、疼痛、發燒等不適症狀；在疾病認知上也缺乏足夠的資訊，造成心理上的焦慮，因此歸納出個案主要的護理問題有：保護能力改變／血小板減少、體溫過高、疼痛、知識不足。經由主動傾聽關懷個案需求，並透過護理活動的介入，降低個案因疾病所引起的牙齦出血、發燒、全身性骨頭酸痛等不適症狀。另針對個案對登革出血熱疾病認知之疑慮處，協助澄清觀念，配合單位衛教本的使用，強化個案對疾病的了解，以減輕心中的焦慮，達到整體性護理的目的。鑑於本土性登革出血熱患者與日增多，筆者藉此個案報告的護理經驗提出與護理人員分享，以做為日後照護此類病患的參考。

The case report presented a patient with dengue hemorrhagic fever after being bitten by an insect in a suburban area. The author observed and interviewed the patient and utilized Gorden's functional health scale to collect information, from Nov., 08 to Nov., 15 2002. Thrombocytopenia, febrile, and pain accompanied with dengue hemorrhagic fever were recorded during nursing evaluation. Lack of associated medical information contributed to the patient's anxiety status. The major nursing problems were changing of protection/thrombocytopenia, hyperthermia, pain, and inadequacy of knowledge. The gum bleeding, fevers, and generalized bone pain were releived by sincere listening and nursing intervention. In addition, medical information was delivered by way of a health information booklet to improve the understanding of the patient and ease the latter's anxiety status. Amid an increase in case of dengue hemorrhagic fever in Taiwan, this case report might provide some valuable information to the nursing staff in order to enhance their ability to provide comprehensive care.