一位初次急性缺血腦中風病人之護理經驗

本文探討一位 46 歲女性因急性缺血性腦中風接受動脈取栓術後加護病房護理經驗。筆者於 2020
年 6 月 20 日至 6 月 27 日止，照護期間運用 Gordon 十一項功能性健康型態評估工具，經身體評估、
收集病史、直接護理、觀察及會談等方式收集資料，確認護理問題有身體活動功能障礙、身體心像紊
亂及知識缺失。照護期間運用同理傾聽與病人建立良好護病關係，結合全人醫療團隊、運用醫病共享
決策，與病人及家屬共同擬定照護計劃，教導復健活動及床上全關節運動，增強肌力恢復；鼓勵病人
表達內心感受，給予正向情緒支持，分享成功案例改善身體心像紊亂問題；主動提供疾病相關知識及
與疾病共存的注意事項，鼓勵病人自主學習相關照護知識，提升自我照護技巧，避免再次發生腦中風。
另外，建議腦中風個管師能於病人入住加護病房時立即收案，讓醫療照護團隊能更好的掌握病人的進
展並提供相關資源，以利病人順利的渡過疾病急性期，回歸正常社交生活。
This article mainly to express the nursing experience of a 46 years old female undergoing
endovascular thrombectomy who first time acute ischemia stroke. The nursing period was from
June 20, 2020 to June 27, 2018. According to the Gordon 11 item functional assessment of health,
data was collected through methods such as physical assessment, medical record review, direct
nursing, observation and interviews. The nursing diagnosis was classified as: dysfunction of
physical activity, body image disturbance, knowledge deficiency. In the nursing time, established a
good nursing relationship by empathy to listening. Teaching rehabilitation activity and total range of
motion in bed to increase muscle power recover by use shared decision marking and combine team
resource management from setting a plan with patient and family. Encourage to express a sense of
humor and give positive emotion support; share the successful case to improve the question of body
image disturbance. Avoid to occur stroke again, supply the knowledge about disease and how to
coexist diseases initiative to encourage self learning for selfcare. In addition, sugget stroke case
manager officer hear a case immediately when the patient into the ICU for return to normail social
life.