一位慢性阻塞性肺疾病急診病患的護理經驗

Nursing Care of an Emergency Patient with Chronic Obstructive pulomonary Disease

本篇是護理一位66歲慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)之男性個案，因呼吸困難至急診求診。於2003年1月12日至1月20日照護期間，筆者以會談及觀察技巧收集資料，並運用Gordon’s十一項功能性健康型態評估為依據，發現個案之健康問題有氣體交換功能障礙、呼吸道清除功能失效、活動無耐力、焦慮、知識缺失。藉由正確呼吸道訓練，適當營養支持，增強個案之獨立性，進而適應疾病變化之過程。自此次護理經驗，透過提供個案身心照顧，使其在生理、心理得到良好的適應，期以此經驗與護理同仁共享，並作為日後照顧此類患者之參考。

The number of patients with chronic obstructive pulmonary disease (COPD) is growing with the gradually deteriorating quality of air in our living environment. By appropriate treatment and nursing procedures, we can lower the frequency of hospitalization, thereby reducing the medical costs and improving patients' quality of life. This paper reports the nursing care of a 66-year-old male patient with chronic obstructive pulmonary disease, who sought medical he1p at an emergency room due to dyspnea. The authors gathered information with skills of conservation and observation as well as application of Gordon's eleven items of evaluation of functional healthy status during the nursing care period between January 12th and January 20th, 2003. We found that the healthy problems of the patient were "ineffective breathing pattern", “ineffective airway clearance" , "anxiety" , "activity intolerance", and "knowledge deficit". By respiratory training and self-care skills, the patient could reduce anxiety and assert his independence, and then become accustomed to the disease process. From this nursing experience, we provided physical and mental care to the patient who therefore acquired good adaptation in the respective fields. We would like to share the experience with all nursing colleagues and provide a reference for caring such patients in the future.