照顧一位年輕型缺血性腦中風之急診護理經驗

Emergency Nursing Care Experience for a Young Adult with Ischemic Stroke

本文探討一位31歲年輕男性急性缺血性腦中風個案的護理經驗。個案因左側肢體無力就醫，診斷為急性缺血性腦中風，並在住院第1天至第4天進行護理。通過會談、身體評估及Gordon 11項功能性健康評估，確立個案存在「身體活動功能障礙」、「焦慮」及「知識缺失」等健康問題。個案對於生活失能的焦慮情緒及擔心拖累家人，影響其康復。護理過程中，透過個別化的措施，提供社會心理支持、正向思考及復健指導，並教育病患認識腦中風與疾病管理，如血壓控制、戒煙戒酒及癢成規律生活習慣，以減少中風再次發生的風險。在急性期，提供適當的護理以減少病情惡化。在急診護理過程中，面對時間與資源的限制，無法立即轉介復健科是主要挑戰之一。為克服這一瓶頸，建議腦中風個案管理師，或專科醫師應該及早進行復健科轉介，並與各專業圄隊協作，提供個案綜合照護。此研究旨在為護理人員提供更多年輕型腦中風的照護依據，提升急診護理專業水準。

This article explores the nursing experience of a 31-year-old male patient with acute ischemic stroke. The patient presented to the emergency department with left-sided limb weakness and was diagnosed with acute ischemic stroke. Nursing care was provided from Day 1 to Day 4. Through interviews, physical assessments, and Gordon's 11 functional health patterns evaluation, health issues such as ''impaired physical activity,'' ''anxiety,'' and ''knowledge deficit'' were identified. The patient expressed severe anxiety about facing life-long disability and fears of becoming a burden to his family. In response, individualized nursing interventions were implemented, including psychosocial support, encouragement of positive thinking, and rehabilitation guidance. The patient was educated on stroke prevention, including blood pressure control, smoking and alcohol cessation, and maintaining a regular lifestyle to reduce the risk of recurrent strokes. During the acute phase, appropriate care measures were provided to prevent further deterioration. A limitation was the inability to refer the patient to the rehabilitation department within the emergency care period. It is recommended that stroke case managers or specialists facilitate early referral to rehabilitation for multidisciplinary intervention, enhancing the patient's quality of life. This study aims to provide nursing professionals with better guidance and evidence for caring for young stroke patients, ultimately improving the quality of emergency nursing care.