一位氣喘病人呼吸衰竭之緊急照護經驗

The Emergent Care Experience of an Asthma Patient with Respiratory Failure

本文描述一位58歲氣喘病人呼吸衰竭的緊急照護經驗。病人因發燒、氣喘發作入院求診，注射退燒藥發生過敏反應而產生喉頭水腫、氣管痙攣導致急性呼吸衰竭，予緊急插管以改善換氣障礙及治療過敏反應。筆者自2012年10月24日凌晨0:20分至5:20分的照護期間，以觀察、訪談、主動關懷和傾聽，利用Gordon 十一項功能健康型態模式評估病人健康問題，確認其健康問題為：低效性呼吸型態、自主換氣障礙及焦慮。筆者運用護理過程解決病人急診留觀期間的身心問題，協助減輕呼吸困難及焦慮情緒，提供完善的照護。希望藉此經驗分享，提供急診護理人員日後照護類似病人之參考。

This article described the emergent care experience of a 58-year old asthma patient with respiratory failure. The patient had asthma attack with fever, and was injected by anti-pyretic drugs which led to allergy and laryngeal edema, bronchospasm and respiratory failure. An endotracheal tube was placed to improve gas exchange and treat allergic reaction. The duration of nursing care was from 0:20 to 5:20 AM on October 24, 2012. Observation, interview, active care, and listening were used to collect patient’s information. Gordon’s 11-item functional Health Pattern assessment was used to assess patient’s health problems. Three health problems were identified: ineffective breathing pattern, impaired gas exchange, and anxiety. The authors provided a comprehensive nursing care to help the patient to relieve psychophysical problems. It is expected that the experience sharing may provide a good reference for nurses to care the similar patents in the future.