慢性阻塞性肺疾病患者氣切後脫離呼吸器之照護經驗

Nursing Experience of a Chronic Obstructive Pulmonary Disease Patient with Tracheostomy Successfully Weaned from Ventilator

10.6692/KJN.202004_37(1).0010

王若瑄(Jo-Hsuan Wang)；賴琦琇(Chi-Hsiu Lai)；李芳儀(Fang-Yi Li)

慢性阻塞性肺疾病 ； 氣切 ； 呼吸器脫離 ； COPD ； Tracheostomy ； Weaning from Ventilator

高雄護理雜誌

37卷1期（2020 / 04 / 01）

112 - 122

繁體中文

本篇是照護一位70歲女性，因慢性阻塞性肺部疾病併呼吸衰竭行氣切手術後，成功脫離呼吸器之護理經驗。護理期間為2014年1月9日至2014年2月3日，筆者以Gordon十一項功能性健康型態為評估指引，運用身體評估、會談及直接觀察等技巧收集主、客觀資料，確立個案主要護理問題有：（一）氣體交換障礙、（二）活動無耐力、（三）無力感。依據台灣肺阻塞臨床照護指引，提供整體與持續性照護並擬定個別性護理措施，透過與其他醫療團隊合作，令個案增進活動耐受力、增強自行清除痰液的能力及提高自信心，促使個案成功脫離呼吸器，恢復良好生活品質。期盼藉此照護經驗的分享，提供護理同仁作為參考。

This article describes the experience of nursing care for a 70-year-old female patient who suffered from COPD and respiratory failure and was successfully weaned from a ventilator after tracheostomy. The caring period was from Jan 9, 2014 to Feb 3, 2014. By Gordon's health patterns as the assessment guide, the author used physical assessment, interviewing and observations to collect relevant subjective and objective information. Nursing diagnoses of the patient were (1) Impaired gas exchange, (2) Activity intolerance, and (3) Powerlessness. Based on Taiwanese clinical practice guidelines on COPD, a complete, continuous, and customized medical treatment was provided. With the collaborative effort of the medical team, the patient increased her endurance and self-confidence, and improved in sputum clearance, becoming successfully weaned from the mechanical ventilator and recovering her quality of life. This article could be used as a reference for clinical nursing practices.