照顧一位原發性肺高壓病人的護理經驗

Nursing Experience for Caring a Patient with Idiopathic Pulmonary Arterial Hypertension

羅喬齡(Chiao-Ling Lo)

原發性肺高壓 ； 皮下注射 ； 自我照護 ； ldiopathic pulmonary arterial hypertension ； Remodulin ； subcutaneous injection ； self-care

若瑟醫護雜誌

10卷1期（2016 / 07 / 01）

85 - 98

繁體中文

本文描述一位年輕女性個案因原發性肺高壓疾病惡化，首次使用Remodulin藥物皮下持續注射方式治療的護理過程，筆者於2013年1月11日至1月21日期問運用觀察、會談方式收集資料，並依照生理、心理、靈性和社會整體性進行評估，確立個案主要的護理問題：心輸出量減少、情緒低落、注射部位疼痛、拒絕學習肺高壓藥物Remodulin施打流程衛教，依個案需求與個案、家屬和醫療團隊共同擬定整體照護計畫，維持個案足夠的心輸出量，陪伴渡過情緒低落的時間，並協助個案學習Remodulin藥物可能的副作用和機器操作流程。藉此分享原發性肺高壓個案的照護經驗，期望能在未來肺高壓病人的護理照護上做為參考。

This report describes the experience of nursing care for a young female with Idiopathic pulmonary arterial hypertension (IPAH) who decided to use subcutaneous injection of Remodulin. Data were collected by using communication with and observing the patient. Physical, mental, spiritual and social integrity were used for holistic assessment from January 11th, 2013 to January 17th, 2013. The major nursing problems included cardiac output reduction. low-spirit status. pain of injection area and uncooperative to learn the subcutaneous injection skill of Remodulin. According to the patient's need, the caring planning established by medical team, we tried to maintain enough cardiac output and keep patient's cooperate to overcome the low spirited time. We also help patient to learn the subcutaneous injection skill and to be able to operate the machine of Remodulin injection. Finally patient could face the disease with the positive attitude and learn to self-care. We also educated patient for the possible adverse effects of Remodulin. This article provides valuable experience and information of clinical care of IPAH patient and hope to improve the clinical care in the future.

1. Guglin, M.,Khan, H.(2010).Pulmonary Hypertension in Heart Failure.Journal of Cardiac Failure,16(6),461-474.
2. Hayes, GB(2012).Pulmonary hypertension a patient’s survival guide. United States.United States, MD:Silver Spring.
3. Hooman, DP.,Corey, EV.(2012).Pulmonary Hypertension in the Intensive Care Unit.Progress in Cardiovascular Diseases,55(2),187-198.
4. Minai, OA.,Parambil, J.,Dweik, RA.,Davila, GH.,Peterson, L.,Rollins, KD.(2013).Impact of switching from epoprostenol to IV treprostinil on treatment satisfaction and quality of life in patients with pulmonary hypertension.Respiratory Medicine,107(8),458-465.
5. Vallerie, VM.,Melinda, D.,William, C.(2011).Pulmonary Arterial Hypertension.Current Problems in Cardiology,36,461-517.
6. 白筱雯,宋怡憓,李彩緣(2012)。照顧一位心臟衰竭病患之護理經驗。若瑟醫護雜誌，6(1)，107-118。
7. 陳資濤,蘇健,吳健樑(2009)。肺動脈高壓的治療。內科學誌，20(1)，9-20。