一位初次確診新冠肺炎病人之護理經驗

A Nursing Experience of a First Diagnosis Covid-19 Patient

本文為一位初次確診新冠肺炎病人的護理經驗。個案除了新興傳染病所引發的不適症狀之外，在急診隔離治療期間因不確定的疾病進展及可能威脅生命，而產生焦躁不安情緒，引發筆者探討動機，護理期間2022年6月23日15：05至6月24日01：18，藉由查閱病歷、身體評估、觀察及訪談等方式收集資料，運用Gordon 11項功能性健康型態進行分析，確立個案健康問題：氣體交換障礙、體溫過高、焦慮。藉由個別性及整體性之護理措施，教導個案正確的深呼吸咳嗽及運用胸腔物理治療等，促進痰液排出，協助採半坐臥姿，依醫囑給氧治療以維持適當的氣體交換；透過冰沈使用，補充足夠水分，適當調整被蓋及更換衣物，以緩解個案體溫過高之不適感；藉由關懷、傾聽以建立良好的護病關係，鼓勵個案表達內心感受，協助藉由宗教信仰、通訊軟體視訊、觀看影片或聽音樂等措施，以緩解個案因健康受威脅所致的焦慮情緒。疫情仍持續發展，建議急症護理人員在穩定病人生理狀態下也需察覺其內心感受，提供合宜措施以降低其焦慮；再者因應疫情變化，護理人員也應多參加相關的研習會，以利臨床面對病人時可提供即時之衛教。期望藉由此照護經驗之分享，提供臨床護理人員照護此類病人之參考。

This article reports on the nursing care of a patient newly diagnosed with COVID-19 who experienced both physical discomfort and psychological distress during isolation. Data were collected from June 23–24, 2022, through record review, assessment, observation, and interviews. Based on Gordon's 11 Functional Health Patterns, three major problems were identified: impaired gas exchange, hyperthermia, and anxiety. Targeted interventions included breathing exercises, chest physiotherapy, semi-Fowler's positioning, and oxygen therapy to improve gas exchange; hydration, cooling measures, and environmental adjustments to relieve hyperthermia; and therapeutic communication, emotional support, and coping strategies such as spiritual practices, video calls, and recreational activities to reduce anxiety. This case highlights the importance of holistic, individualized nursing care in emergency settings. Nurses should address both physiological stability and psychological well-being while continuing professional education to strengthen timely health education and support for patients with COVID-19. By sharing this care experience, the article aims to serve as a reference for clinical nurses caring for similar patients.