一位心律不整導致休克青少年於復原期之護理經驗

Nursing Experience from Caring of a Youth with Arrhythmia Caused by Shock During the Recovery Period

10.29494/LN.201809_19(3).0005

蔡怡慧(Yi-Hui Tsai)；林宥葶(Yu-Ting Lin)

心律不整 ； 青少年 ； 復健 ； Arrhythmia ； Teenager ； Rehabilitation

領導護理

19卷3期（2018 / 09 / 01）

50 - 65

繁體中文

本文主要描寫一位心律不整導致休克青少年於復原期之護理經驗，個案突然昏倒於課堂上經急救治療後，進入復健及學習居家照護階段，發現個案情況帶來的家庭衝突，引發筆者探討照護之動機，筆者於2017/5/17-2017/6/23照護期間，以羅氏適應模式為評估基礎，經由觀察、會談、身體評估及直接照護等方式收集資料，針對個案三個主要健康問題：一、尿瀦留/與疾病造成腦損傷導致無法自解尿液。二、自我照顧能力缺失/與疾病導致腦損傷無法自理生活有關。三、照顧者角色緊張/與不知如何照顧及無可利用資源有關。筆者依據各項健康問題給予相對應護理措施，如尿管訓練、復健活動、家庭會談與支持等，以改善個案生活自理能力，並增加家庭支持正向力、家中成員的支持等，期望此護理經驗能使護理人員了解心律不整造成腦部損傷之青少年於復原期照護需求、疾病對於家屬生活上的衝擊及心理支持，並以提升住院期間之照護品質。

This article narrates the nursing experience from caring an teenager with arrhythmia caused by shock during the recovery period. The teenager collapsed abruptly in the classroom. We gave him first aid treatment, after regain consciousness, he entered pediatric ward to start rehabilitation and home care. During caring this patient, we found the case had initiated the family conflict. So, it inspired the author to explore the motivation behind this case. The period covered from May 17 to June 23, 2017. The patient was assessed by means of observation, interviewing and physical assessments. There were three major health problems: (1) Urinary retention/ brain damage caused the disability of self-voiding, (2) Self-Care deficit/ disease can lead to brain injury and unable to take care of oneself and (3) Caregiver nervous/ caused by not knowing how to care and no resources were available. The author based on the health problems given to the corresponding nursing measures, such as folly training, rehabilitation activities, family talks and family support to improve self-care for the patient. By improving family support positively with other family members, this nursing experience hopefully enable nurses to understand a teenager patient with arrhythmia resulted from brain damage will recover with rehabilitation. By studying how the disease impacted his family life and how to give him psychological support. Hence improve the quality of care during hospitalization.

1. 周靜儀,陳姿燕,羅琦(2017)。致命性心律不整導致猝死後裝置體內去顫器病人之調適歷程。護理雜誌，64(1)，120-126。
   連結：
2. Saito, N.,Taru, C.,Miyawaki, I.(2012).Illness experience:Living with arrhythmia and implantable cardioverter defibrillator.Kobe Journal of Medical Sciences,58(3),72-81.
3. 吳承學,劉慧玲(2011)。低溫治療於心跳停止復甦後病人之應用與照護。榮總護理，28(4)，334-340。
4. 林慧玲,楊麗玉(2014)。一位動靜脈畸形併腦出血青少年術後恢復期之照護經驗。志為護理，13(3)，118-128。
5. 胡芳文,陳清惠,張家銘(2013)。以實證探討住院老人移除留置尿管處理方案。台灣老年醫學暨老年學雜誌，8(1)，1-13。
6. 陳月枝（校閱）(2017).實用兒科護理.台北市:華杏.
7. 陳巧芳(2010)。協助一位主要照顧者降低壓力源之護理經驗。護理雜誌，57(2)，81-86。
8. 陳麗紋,童蔘美,林月娥(2014)。照護一位年輕型中風病人之護理經驗。志為護理─慈濟護理雜誌，13(6)，72-83。
9. 廖芸禪,楊舒琴(2012)。一位急性骨髓性白血病個案接受化學治療之護理經驗。新臺北護理期刊，14(2)，97-106。
10. 衛生福利部(2017，7 月)‧105 年國人死因統計結果‧取自http://www.mohw.gov.tw/cp-16-33598-1.html