护患情境会话



护患情境会话

先天性心脏病合并感染的护理

Nursing Care for a Child with Congenital Heart Disease and Infection

交流

护士：我先给孩子灌肠吧，这样一直哭闹对孩子的病不好的。

患儿妈妈：好的。 (调整患儿体位, 配合护士灌肠)

(小孩安静入睡了，护士再次来到床边)

患儿妈妈：护士小姐，我们小孩的心脏病，有治好的办法吗？

护士：有的！我看过您小孩的临床资料，是室间隔缺损，缺口比较小，大约0.5 cm。解剖部位也还好，以后不用开刀。做介入封堵就可以把缺口补好，损伤小，两、三天就可以出院。现在我们病区做这类封堵术的小孩蛮多的，隔壁房间就有两个。

患儿妈妈：我们小孩现在能做吗？

护士：最好3到5岁左右，小孩这时候的耐受力比较好，也不影响学习。现时注意避免受凉感冒，避免强烈刺激，少到人群集中的地方，注意加强营养，保持大便通畅。这些等到出院前，还会给您发健康教育指导处方的。

患儿妈妈：谢谢你，我实在太着急、太紧张说话有些激动，请原谅。说句老实话，两天下来感觉这里服务态度蛮好的。小孩住在这里我也放心了。

护士：感谢您对我们工作的支持，以后我们彼此多交流多沟通。

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.

点评

先天性心脏病合并肺部感染在临床中很常见。当小孩发生感染，由于抗病能力相对较差，持续时间长，同时心脏症状加重，会出现相关呼吸系统和循环系统症状。此时家长会不知如何是好，着急、紧张、烦躁随之而来。此时护理人员要沉住气，用耐心、爱心、诚心去化解他们心中的焦虑与不安，增加他们对护理人员的信任感。同时让家长明白自己小孩的一些情况及目前医疗进展动态，使他们对治疗充满希望，并增加主动地配合护理人员的工作。

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.

(曾梅凤)