肺結核合併頑固性肋膜積水病患之護理經驗

Nursing Experience with a Pulmonary Tuberculosis Patient who has Refractory Pleural Effusion

10.6200/TCMJ.2012.9.4.12

樊修珊(Shiou-Shan Fan)；余錦美(Ching-Mei Yu)

肺結核 ； 肋膜積水 ； 胸管 ； pulmonary tuberculosis ； pleural effusion ； chest tube

北市醫學雜誌

9卷4期（2012 / 12 / 01）

419 - 427

繁體中文

本文旨在描述肺結核病人合併頑固性肋膜積水長期接受胸管治療時，因胸管自我照護能力不足反覆住院之護理經驗。護理期間為2010年5月29日至6月10日，藉由運用Gordon十一項功能健康型態評估方法，確立病人有焦慮、無效性健康維護能力、現存性營養少於身體需求及潛在危險性感染等健康問題，針對病人採個別性護理措施，提供肋膜積水相關知識，經由會談減緩病人焦慮，教導胸管及傷口自我照護之技巧，並提供相關飲食指導，此個別化護理措施成功地解決病人生理及心理的相關問題，進而提升病人之居家生活品質及降低病人反覆住院之情形。

This article describes nursing experience during the repeated hospitalization of a pulmonary tuberculosis patient with refractory pleural effusion due to poor self-care of a chest tube after long-term chest tube drainage treatment. The observation period was from May 29 to June 10, 2010. Using Gordon's 11-items functional health scale, many problems were identified including anxiety, ineffective health maintenance, nutritional disequilibrium, and the potential risk of infection. On the basis of these identified problems, individual nursing strategies were implemented, including providing better knowledge of pleural effusion to the patient, decreasing the patient's anxiety by personal interview, instructing the patient in the skills required to care for the wound and chest tube, and supplying the patient with a dietary guide for pleural effusion patients. As a result of these interventions, the physical and psychological problems of patient were successfully resolved by the individual nursing and, furthermore, the quality of life of the patient was improved in parallel with a reduction in repeat hospitalization of the patient.