一位羊水栓塞重症末期產婦之綏和臨終照護經驗

Nursing Experience of a Pregnant Woman in a Critical Condition Who Underwent Amniotic Fluid Embolism and Terminal Palliative Care

10.6142/VGHN.201809_35(3).0003

陳佩玉(Pei-Yu Chen)；陳雅惠(Ya-Huei Chen)；蔡寶純(Bao-Chuem Tsai)；林蓮馨(Lian-Shin Lin)

羊水栓塞 ； 臨終護理 ； 加護護理 ； amniotic fluid embolism ； terminal care ； intensive care

榮總護理

35卷3期（2018 / 09 / 01）

245 - 252

繁體中文

本文是探討一位經產婦於生產時發生羊水栓塞，經急救後入住加護病房緩和照護經驗。護理期間自2017年3月16日至2017年4月10日，運用Gordon十一項功能性健康型態做整體性護理評估，護理過程中藉由直接照護、觀察、傾聽、關懷、身體評估及查閱病歷等方式收集資料，發覺個案有自我照顧能力缺失、家屬抉擇衝突、預期性哀傷等主要護理問題。護理期間提供病人舒適護理，顧及病人隱私與尊嚴，引導家屬思考個案生前對罹患不可逆疾病時的心願，協助家屬四道人生以調適將失去親人的傷痛，個案最後得以尊嚴往生。故建議加護病房的醫療人員皆應接受安寧緩和之專業訓練，才能提升末期重症病人之照護品質。

This article details the nursing experience of palliative care for a terminal patient in the intensive care unit (ICU), which resulted in a dignified death. A multigravida experienced amniotic fluid embolism during delivery and was admitted to the ICU after emergency treatment. However, hypoxic encephalopathy complications occurred, after which palliative care was provided. The woman ultimately had a dignified death. Care was provided from March 16 to April 10, 2017. Gordon's eleven functional health patterns were utilized as a guide for evaluations. Data were collected through direct care, observations, listening, caring, and physical examination as well as from medical records. Major nursing issues such as self-care deficit, family decision conflicts, and anticipatory grief were all observed in this case. Therefore, comfort nursing care was offered to assist the patient maintain basic physical demands, protect privacy, and ensure dignity. A strong patient-nurse relationship was also established. In this article, the concepts of palliative care in critical terminal care are introduced.

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