運用周全性老年評估照顧一位急性混亂個案之護理經驗

The Nursing Experience of a Patient with Acute Confusion to Apply Comprehensive Geriatric Assessment

曾怡菱(Yi-Ling Tseng)；曾惠珍(Hui-Chen Tseng)

周全性老年評估 ； 急性混亂 ； 護理 ； comprehensive geriatric assessment ； acute confusion ； nursing

嘉基護理

18卷1期（2018 / 06 / 01）

25 - 36

繁體中文

本文係探討一位常規血液透析之養護機構老年人因發燒、心律不整入院求治，住院後發生急性混亂之護理經驗。照護期間以周全性老年評估作為指引，進行整體性評估，並以直接照顧、會談、觀察、身體評估方式收集資料，個案主要護理問題為急性混亂，給予感染引發體溫過高的治療、認知功能恢復、睡眠週期維持及避免發生合併症之急性混亂照護，達到認知情況改善與預防身體功能衰退之目標；另外，外籍照服員之主要照顧者表示對混亂症狀感到害怕、焦慮，乃運用簡體版衛教手冊，提供急性混亂照護技巧，緩解外籍照服員的焦慮感，減輕照顧負荷之發生。希望藉由此護理經驗分享，提供護理人員在照護老年急性混亂病人及其主要照顧者時之護理指導參考。

This article described a nursing experience of a geriatric patient with acute confusion who lived in long-term care institution and receiving regular hemodialysis. He admitted to hospital due to fever and arrhythmia, which had the status of acute confusion after his hospitalization. He was taken the comprehensive geriatric assessment (CGA) as the guide during admission, including the assessment of acute confusion. The data was collected by direct care, interview, observation, and physical assessment. According to the data collected, the main health problem of this patient was the acute confusion. In order to achieve the goal of recovering previous cognitive function and preventing decline in physical function effectively, the nursing interventions included the treatment of the fever caused by infection, recovering cognitive function, maintaining sleep cycle and preventing complications. On the other hand, the foreign caregiver had expressed that she had fear of the patient's confusion symptoms, and anxiety of caring this patient. As a result, acute confusion care skills were provided through the simplified Chinese version health education manual. By the repetition of demonstrated skills and psychological support, the fear and anxiety of the foreign caregiver was relieved and the burden of caregiver was also reduced. The nursing experience would offer a useful reference of nursing care on acute geriatric confusion patients and their main caregivers.

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