一位確診新冠肺炎病人調適生活之護理經驗

A Nursing Experience of a COVID-19 Patient Undergoing Life Adjustments Nursing

陳昕妤(Sin-Yu Chen)；趙麗玫(Li-Mei Jhao)；曾瓊誼(Chun-Yi Tseng)

新冠肺炎 ； 體溫過高 ； 焦慮 ； 調適生活 ； COVID-19 ； Hyperthermia ； Anxiety ； Adjustment impaired

若瑟醫護雜誌

16卷1期（2022 / 03 / 01）

67 - 79

繁體中文

本文探討一位確診新冠肺炎病人調適生活之護理經驗，病人面對突如其來的染疫且一再復陽，歷經長時間隔離致使生、心理受到衝擊之護理過程。自2020年3月26日至2020年4月17日，經由觀察、直接照會、傾聽、會談及身體評估等方式進行收集資料，依據Gordon十一項功能性健康型態評估，確認病人的健康問題為：「體溫過高」、「低效性呼吸型態」、「焦慮」、「調適障礙」。病人確診新冠肺炎，出現類流感如：發燒、呼吸喘等症狀，初期針對病人的個別性需求，提供症狀治療及氧氣需求，教導咳嗽技巧和噘嘴式呼吸，促進痰液排除和放鬆呼吸肌，以緩解病人身體的不適感。由於病人反覆「陰轉陽」，活動受限，無法調適情緒影響生活，且極度擔憂染疫後的合併症，透過全人整合醫療照護，提供疾病的新知及治療程序，緩解其焦慮感受。期望藉此讓護理人員未來面對確診新冠肺炎之病人，能用豐富的照護經驗，建立臨床相關指引，以控制院內傳染並協助病人儘早康復返家。

Marfan syndrome is an autologously genetic disease that affects connective tissue. The patient will experience abnormalities in the cardiovascular system, which can lead to aortic dissection. Aortic dissection is a cardiovascular emergency. If it is not diagnosed and treated in time, the mortality rate increases by 1-2% every hour at the beginning of the symptoms. This article discusses a 28-year-old hospitalized for the first time with Marfan syndrome and was in the emergency department due to acute chest pain Department tracking chest computerized tomography diagnosed Type A aortic dissection, and urgently performed aortic root mechanical valve and valve tube replacement (Bentalls) operation, and was transferred to the general ward after observation in the intensive care unit. The ward care period from July 23 to August 5th in 2018, collect data through observation, interviews and access to medical records, and after Gordon's eleven nursing assessments, care problems such as acute pain, respiratory tract clearance failure, anxiety, have been drawn up and a care plan has been drawn up by accompanying , Listening, discussion and demonstration, establish therapeutic interpersonal relationship with the case, and assist the case to establish correct concepts for pain relief, postoperative blood pressure control, wound care and daily adaptation. Hope to take advantage of the case's illness Provide care reference for diagnosis and nursing process.

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