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護(hù)患情境會(huì)話(huà)

先天性心臟病合并感染的護(hù)理

Nursing Care for a Child with Congenital Heart Disease and Infection

交流

護(hù)士：我先給孩子灌腸吧，這樣一直哭鬧對(duì)孩子的病不好的。

患兒媽媽?zhuān)汉玫摹?(調(diào)整患兒體位, 配合護(hù)士灌腸)

(小孩安靜入睡了，護(hù)士再次來(lái)到床邊)

患兒媽媽?zhuān)鹤o(hù)士小姐，我們小孩的心臟病，有治好的辦法嗎？

護(hù)士：有的！我看過(guò)您小孩的臨床資料，是室間隔缺損，缺口比較小，大約0.5 cm。解剖部位也還好，以后不用開(kāi)刀。做介入封堵就可以把缺口補(bǔ)好，損傷小，兩、三天就可以出院。現(xiàn)在我們病區(qū)做這類(lèi)封堵術(shù)的小孩蠻多的，隔壁房間就有兩個(gè)。

患兒媽媽?zhuān)何覀冃『F(xiàn)在能做嗎？

護(hù)士：最好3到5歲左右，小孩這時(shí)候的耐受力比較好，也不影響學(xué)習(xí)?，F(xiàn)時(shí)注意避免受涼感冒，避免強(qiáng)烈刺激，少到人群集中的地方，注意加強(qiáng)營(yíng)養(yǎng)，保持大便通暢。這些等到出院前，還會(huì)給您發(fā)健康教育指導(dǎo)處方的。

患兒媽媽?zhuān)褐x謝你，我實(shí)在太著急、太緊張說(shuō)話(huà)有些激動(dòng)，請(qǐng)?jiān)?。說(shuō)句老實(shí)話(huà)，兩天下來(lái)感覺(jué)這里服務(wù)態(tài)度蠻好的。小孩住在這里我也放心了。

護(hù)士：感謝您對(duì)我們工作的支持，以后我們彼此多交流多溝通。

Interactions

Nurse: I’ll give the child an enema first. It is not good that he keeps crying and screaming.

Patient’s Mother: OK. (Adjusting the baby’s body posture to go with the nurse’s enema procedure)

(The baby fell asleep. The nurse came to his bedside again)

Patient’s Mother: Nurse, is there any method of curing our baby’s heart disease?

Nurse: Yes! I have read your child’s clinical data. He has the ventricular septal defect about 0.5 cm. There is no need to have an operation. We can use an interventional method to block it which has very little trauma to him. He can be discharged from the hospital within 2 to 3 days. There are many children cured using this method in our department. As matter of fact, there are two of them right now in the next room.

Patient’s Mother: Can our baby be treated with this procedure now？

Nurse: It is better to do it at about three to five years old when the child’s tolerance is better. At that age the child is not yet attending school, therefore it will not interfere with his study. At the present time, you should make sure that your child will not catch cold, prevent him from strong stimulation, and don’t take him to crowded places. Pay attention to his nutrition, and keep his bowel movement smooth. We will give you a brochure with more information and health guidelines before you leave the hospital.

Patient’s Mother: Thank you. Because I was so worried, I might have talked to you very rude. Please forgive me. Frankly, I feel the service here is quite good. I do not worry any more about my baby staying here.

Nurse: Thank you for supporting our work. From now on, we should communicate with each other more often.

點(diǎn)評(píng)

先天性心臟病合并肺部感染在臨床中很常見(jiàn)。當(dāng)小孩發(fā)生感染，由于抗病能力相對(duì)較差，持續(xù)時(shí)間長(zhǎng)，同時(shí)心臟癥狀加重，會(huì)出現(xiàn)相關(guān)呼吸系統(tǒng)和循環(huán)系統(tǒng)癥狀。此時(shí)家長(zhǎng)會(huì)不知如何是好，著急、緊張、煩躁隨之而來(lái)。此時(shí)護(hù)理人員要沉住氣，用耐心、愛(ài)心、誠(chéng)心去化解他們心中的焦慮與不安，增加他們對(duì)護(hù)理人員的信任感。同時(shí)讓家長(zhǎng)明白自己小孩的一些情況及目前醫(yī)療進(jìn)展動(dòng)態(tài)，使他們對(duì)治療充滿(mǎn)希望，并增加主動(dòng)地配合護(hù)理人員的工作。

Comments

It is very common that children with congenital heart disease also develop lung infection. The infection sometimes may lasts for a long time because of the child’s decreased immunity and this in turn could worsen the heart condition. When this situation happens, the parents usually do not know what to do. They become extremely worried, anxious and easy to be irritated. Nurses at this time should keep calm and try to alleviate their anxiety and worries with patience, love and sincerity, so to increase their trust in the nursing staff. The nurses should also let the parents understand their child’s situation and the progress of the treatment. This will enhance their hope of their child’s recovery and increase their willingness to cooperate with the nursing staff.

(曾梅鳳)