一位初次氣喘急性發作患者致呼吸困難之加護經驗

Patients with an initial acute attack of asthma breathing difficulties caused by the intensive care experience

本文為一位22歲男性體育系大學生，因呼吸困難而插管之加護病房護理經驗。氣喘病患為發作前與常人無異，但若未確實控制，嚴重者將導致反覆發作，終身須仰賴呼吸器。本案患者為初次器喘發病的體育系學生，需特別建立個案自我保護意識，使其能隨時注意以避免反覆發作而影響未來選手生涯。本案護理期間為2013年3月12日至3月16日，筆者採用Gorden十一項健康功能評估方法，且進行身、心、社會整合評估，發現個案主要健康問題為呼吸道清除功能失效、知識增進準備度不足及照顧者腳色緊張。筆者針對健康問題於照護期間，維持病患足夠的氣體交換使其呼吸順暢、情緒平穩，並鼓勵個案表達自我感受，採正向態度面對疾病治療過程，教導疾病資訊之取得方式，增進對自身疾病的瞭解及日常生活預防及保健，也同時提供個案及案母氣喘症狀評估與症狀自我處理的方式，及氣喘相關照顧方法，並特別請一位曾反覆發作的氣喘並有提供現身說法，以建立個案強烈的自我保護意識。筆者建議護理人員能善加利用介紹病友互相認識的方式，互相鼓舞、扶持，並期望藉此護理經驗能提供其他護理人員日後照護此類病患之參考。

This article reports a nursing experience of caring for a 2-year-old college student with an acute asthma attack. The patient was intubated for dyspnea in the intensive care unit. Although a patient with asthma usually does not look different, without well-controlled and repeated episodes of an attack, the patient may suffer from being ventilator-dependent for the rest of his or her lifetime. The patient was a college student with a major in Physical Education. Developing self-protective conscientiousness prevents the patient from potential repeated asthma attacks and further endangerment of his athletic career. The nursing care period was from March 12 to 16, 2013. Gordon’s 11 functional health patterns assessment tool was used for physical, psychological, and social assessment. The major health problems included ineffective airway clearance, lack of knowledge in asthma care, and role stress for experience sharing for strong enhancement of self-protective conscientiousness. The author suggests making the best use of a case support group for mutual support and encouragement. This nursing experience can be used as a care reference for other nurses caring for patients with the same diagnosis.