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    Please use this identifier to cite or link to this item: https://ir.fy.edu.tw:8080/ir/handle/987654321/593


    Title: 一位心因性肺水腫併發呼吸衰竭患者脫離呼吸器之護理經驗
    Authors: 黃碧華;蕭雅莉
    Contributors: 輔英科技大學 護理系
    Keywords: 心因性肺水腫;呼吸衰竭;脫離呼吸器;Cardiogenic pulmonary edema;Respiratory failure;Weaning from ventilator
    Date: 2008-05-01
    Issue Date: 2010-09-21 15:48:26 (UTC+8)
    Abstract: 本文旨在探討照顧一位因二尖瓣閉鎖不全導致急性肺水腫而引發呼吸衰竭病患,進行脫離呼吸器之護理經驗,在護理期間筆者運用Gordon十一項功能性健康型態評估作深入探討,發現個案有心輸出量減少、氣體交換障礙及焦慮等健康問題。在照護期間筆者密切觀察心輸出量減少之臨床症狀與徵象,並提供適切的照護活動,以減輕個案之不適;並教導個案運用有效深呼吸咳嗽方法,以利二氧化碳排出,提升肺部通氣功能,進而改善氣體交換障礙情形;在呼吸訓練期間個案因自拔氣管內管後,經歷再次插管,擔心呼吸器脫離失敗,因此筆者不斷藉由紙筆方式與個案溝通,鼓勵及引導說出心裡的感受,介紹鄰床呼吸器脫離成功的個案以增加信心,且運用家屬之支持與關懷,成功的緩解個案的焦慮,使其順利拔管轉出加護病房。期望藉此經驗可提供日後照顧類似個案的護理人員,能同理、了解呼吸器脫離過程中個案的症狀及感受,以提供身、心之整體性照護。
    This paper aimed to present the nursing experience of a patient with acute pulmonary edema caused by mitral valve insufficiency being weaned successfully from ventilator. Nursing assessment was based on the framework of Gordon's 11 functional evaluations. Three health problems, including decreased cardiac output, impaired gas exchange, and anxiety, were found. In order to provide good nursing care and reduce the suffering of the patient, the author taught the patient to promote the performance of the lungs through deep breathing and coughing, which is capable of exhausting co2 from the lungs and improve the condition of impaired gas exchange. During mechanical ventilation, the patient was self-extubated from the ventilatory support deliberately. After the reintubation, writing notes in communication was used for encouragement and helping the patient to express their innermost thoughts. In order to enhance the patient's confidence for successful weaning from the ventilator, the author introduced the successful case of the neighboring patient. In addition, family involvement and support was crucial to the patient's success in weaning from a ventilator in this case. Psychological and physiological nursing experience is presented to understand the nursing process of a patient weaning from ventilation for a similar case.
    Relation: 高雄護理雜誌 25(1),48-60
    Appears in Collections:[護理系] 期刊論文

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