護(hù)患情境會(huì)話

老年人濫用藥物的護(hù)理措施

Nursing Interventions for Abuse of Medication by Elderly

背景

病人吳先生，62歲，因不明原因的神志不清半小時(shí)收住入院。入院后急查血生化，發(fā)現(xiàn)血糖2.6mmol／L。初步診斷：低血糖昏迷。患者有2年的糖尿病史。經(jīng)搶救，患者神志逐漸轉(zhuǎn)為清醒。張護(hù)士來(lái)到吳先生身邊。

Background

Patient Mr.Wu，62years old，was admitted to the hospital after falling unconscious because of some unknown reason for half an hour.Emergency biochemistry tests were conducted and the results revealed that his blood sugar was only 2.6mmol／L.Initial diagnosis was：hypoglycemia coma.The patient had diabetes mellitus for 2years.After emergency treatment the patient gradually recovered his consciousness.Nurse Zhang went to talk to him.

交流

護(hù)士：吳先生，您好，我是您的床位護(hù)士，我姓張，您叫我小張吧。您現(xiàn)在有什么不舒服嗎？

病人：就是覺(jué)得全身沒(méi)力，其它沒(méi)什么。

護(hù)士：聽(tīng)您女兒說(shuō)，您有糖尿病，是嗎？

病人：兩年前醫(yī)生就說(shuō)我有輕度糖尿病，要我飯吃得少一點(diǎn)，平時(shí)多點(diǎn)活動(dòng)，血糖就能控制了。但幾天前我有點(diǎn)感冒，來(lái)醫(yī)院驗(yàn)血后發(fā)現(xiàn)血糖蠻高的，醫(yī)生要我吃藥，說(shuō)是可以降血糖的。

護(hù)士：您在醫(yī)院里配醫(yī)生開(kāi)給您的藥了嗎？

病人：沒(méi)有。聽(tīng)說(shuō)醫(yī)院里的藥要比外面藥店里的藥貴一點(diǎn)，我就不在醫(yī)院里配了，我是自費(fèi)的，想省點(diǎn)錢。

護(hù)士：后來(lái)呢？

病人：昨天我拿著醫(yī)生的處方去我家附近的藥店買了藥。今天早晨，我想醫(yī)生說(shuō)我血糖蠻高的，我就吃了1粒降糖藥。沒(méi)多長(zhǎng)時(shí)間我覺(jué)得心慌，后來(lái)就迷迷糊糊了。

護(hù)士：您當(dāng)時(shí)有出汗嗎？

病人：我出了一身冷汗。張護(hù)士，您能告訴我，我生了什么病？

護(hù)士：楊先生，您吃的降糖藥的量多了一點(diǎn)，使您的血糖降得太低了，就出現(xiàn)了這種情況。

病人：哦，那我下次少吃點(diǎn)，行嗎？

護(hù)士：不行，您得聽(tīng)醫(yī)生的，醫(yī)生要根據(jù)您的血糖調(diào)整藥物用量。另外，您以后身邊帶點(diǎn)餅干或糖果之類的東西。

Interactions

Nurse：Hello，Mr.Wu.I’m the nurse in charge of your treatment.My last name is Zhang，so you can call me Xiao Zhang.Well，how do you feel now？

Patient：I’m all right except feeling fatigue all over my body.

Nurse：I’ve heard from your daughter that you have diabetes mellitus.Is that true？

Patient：Two years ago my doctor told me that I had mild diabetes.He said that my blood sugar would be controlled if I took a restricted diet and exercised more often.However，I caught a cold a few days ago and had my blood sugar level checked at the hospital，the level was high.The doctor told me to take some medications to lower my blood sugar.

Nurse：Did you buy those drugs the doctor prescribed for you from the hospital pharmacy？

Patient：No，I didn’t.I heard that the price of drugs in the hospital was a little higher than the drug stores outside，so I did not buy them in the hospital.I wanted to save some money because I have to pay all my medical expenses by myself.

Nurse：What happened to you then？

Patient：Yesterday，I bought the drugs as prescribed by my doctor from a drug store near my home.As my doctor told me that the level of my blood sugar was considerably high，I took one pill this morning.I soon felt palpitations and became unconscious.

Nurse：Were you sweating at that time？

Patient：I had cold sweat all over then.Ms.Zhang，could you tell me what my disease is？

Nurse：Mr.Yang，this happened to you because you took an excessive dose of drugs that lowered your blood sugar too much.

Patient：Oh，then I should take less drugs the next time，right？

Nurse：No.You should follow your doctor’s advices.He will adjust the dosage according to your blood sugar level.Moreover，you need to carry some biscuits or candy with you all the time.

（汪小華）