照顧一位學齡前期兒童急性氣喘之護理經驗

Nursing Experience of Caring for a Preschool Child with Acute Asthma

本文描述一位急性氣喘發作之學齡前期兒童的住院護理經驗。護理期間自2019年11月14日至2019年11月17日，筆者以Gordon十一項功能性健康型態為評估工具，藉由直接照顧、觀察、會談、身體評估及傾聽等技巧收集資料，確立個案護理問題為低效性呼吸型態∕與氣管產生黏膜水腫及痙攣有關；恐懼∕與醫療處置、照顧者分離及陌生環境有關；照顧者角色緊張∕對疾病認知及照顧知識不足有關。針對上述護理問題，於照護過程中維持病患呼吸道順暢、情緒平穩，且運用個案熟悉物品，轉移注意力並選擇符合個案發展之治療性遊戲，與個案建立信任關係並減緩住院期間身體的不適及分離焦慮，提供家屬疾病相關照護資訊及鼓勵參與照護計畫，提升照護品質、加強家屬照顧能力，使其返家後仍維持良好的生活方式。筆者建議可強化護理師治療性遊戲訓練及設計友善遊戲照護道具以利臨床運用，後續照護建議可加入氣喘照護個案管理團隊，提供完善持續性照護，期望藉此護理經驗分享，提供護理同仁照顧此類個案之參考。

This article describes the hospital care experience of a preschool child with an acute asthma attack. During the nursing period from November 14, 2019 to November 17, 2019, the author used Gordon's eleven functional health types as an assessment tool, and collected data through direct care, observation, interview, physical assessment, and listening techniques. Establishing the case care problem as inefficient breathing pattern∕related to tracheal mucosal edema and spasm; fear∕related to medical treatment, separation of caregivers and unfamiliar environment; stressful role of caregivers∕related to insufficient knowledge of disease and care. In response to the above-mentioned nursing problems, maintain the patient's airway smoothness and emotional stability during the nursing process, and use the familiar objects of the case, divert attention and choose therapeutic games that suit the case's development, stablish a trusting relationship with the case and alleviate physical discomfort during hospitalization. Separation anxiety, provide care information related to family diseases and encourage participation in care plans, improve the quality of care, strengthen the capacity of care for the family members, so that they can maintain a good lifestyle after returning home. The author suggests strengthening the therapeutic game training of nurses and designing friendly game care props to facilitate clinical use. Suggestions for followup care can be added to the asthma care case management team to provide complete continuous care. I hope to share nursing experience and provide nursing colleagues to take care of such cases.