照顧一位肺泡蛋白沉著症病患之護理經驗

Nursing Experience of a Patient with Pulmonary Alveolar Proteinosis

呼吸是一個人與生俱來的本能，若這項功能受損，且需藉由經常性的醫療協助才能存活，不僅對病患及家屬在生理及經濟上造成負荷，且因病患需屢次面對治療造成之死亡威脅更易引發嚴重的心理壓力。本篇藉由一位罹患肺泡蛋白沉著症需使用呼吸器以進行洗肺之病患，在加護病房期間運用Gordon十一項健康功能為評估架構，收集、分析資料，確立病患的健康問題為氣體交換障礙、呼吸器戒斷反應功能失常、體液容積過多、睡眠型態紊亂、焦慮。針對個案的身心健康需求提供個別性護理計劃，以護理人員專業知識與技能，協助病患處理身心健康問題，並使病患能度過危險階段順利完成治療。由於國內類似個案少見，故藉此護理經驗做為日後照護此類病患之參考。Respiration is a natural movement. Once the respiratory function is impaired, the patient usually depends on the medical intervention for survival. In addition to physiologic and economic loadings, this disease also causes the patient under great emotional tension due to frequently facing with life threatening risks of therapy. This report discussed a victim of alveolar proteinosis who was depending on bronchoalveolar larvage for treatment in the intensive care unit. Based on the Golden’s eleven functional evaluation of health, we confirmed that the patient’s health problems were gas-exchange impairment, dysfunctional ventilatory weaning response, fluid volume excess, sleep pattern disturbance, and anxiety. We provided individualized nursing care based on the patient’s needs. We used our professional knowledge and skill to aid the patient to deal with her health problems and accompany her go through the risky period of therapy. This is a rare case, we provide and share the nursing experience with other nursing staffs.