一位慢性阻塞性肺疾病重症個案之加護經驗

An Intensive Care Experience with a Patient Suffering from Chronic Obstructive Pulmonary Disease

本文描述一位慢性阻塞性肺疾病重症個案初次插管治療及成功脫離呼吸器的加護經驗。護理期間自2012年1月29日至2012年2月16日，以Gordon十一項健康功能評估為架構，於護理過程中運用身體評估、會談、病歷查閱等方式收集資料，歸納分析個案有氣體交換障礙、活動無耐力、焦慮及因應能力缺失等健康問題。筆者擬定個別性護理計劃，協同醫療團隊、個案及家屬參與漸進式呼吸訓練及活動力促進方案，輔以跨團隊完整性照護計畫，進而成功脫離呼吸器；適時介入疾病衛教及出院準備服務，透過居家呼吸照護資訊及社會資源的運用鼓勵家屬參與照護，增加個案自我照護能力，使個案能有連續性整體的醫療照顧，以達到全人護理。

This paper described an intensive care nursing experience with a patient suffering from　obstructive pulmonary disease with severe cases of initial intubation treatment. This patient was　successfully removed from the breathing apparatus. The nursing care period was from January 29th　to February 16th in 2012. Data was collected under the frame of “Gordon's 11-item Functional Health Status” together with physical examination, interviews and daily nursing care. We found that the patient had problems including gas exchange barrier, activity intolerance, anxiety and a lack of response capacity. In collaboration with the case, the medical team and the family participated in the progressive breathing exercises and activities to promote the program, and had a complete care plans with different teams. Therefore, the patients would eventually be relieved from the breathing apparatus and released from the hospital by in-home respiratory care and community resources. We encourage the family to participate in increasing self-help ability of the patient in order to help the patient receive a complete nursing process.