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·英語學(xué)習(xí)·

護(hù)患情境會話

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

患兒媽媽：你們竟揀好聽的說。我們一千多塊錢花進(jìn)去了，連個發(fā)燒都退不下來。小孩哭鬧不停，一點(diǎn)都不見好轉(zhuǎn),一定是你們的治療措施不當(dāng)，用藥不當(dāng)。醫(yī)生呢？我要見醫(yī)生。

護(hù)士：我正要請醫(yī)生來看看的。你們稍等，我馬上去請醫(yī)生。(醫(yī)生看過患兒之后，給予藥物降溫，并開出水合氯醛灌腸的醫(yī)囑)

護(hù)士：醫(yī)生檢查過后，開了新的退熱藥，我現(xiàn)在就給他用上，再給他溫水擦個身。等一會體溫會降下來的，接下來馬上給你的孩子灌腸，孩子就安靜了。

患兒媽媽：發(fā)燒就推藥，過一陣子又會升上去，孩子哭鬧了就灌腸，難道你們就沒有其他辦法？

護(hù)士：楓楓媽媽，對不起，讓您著急了。目前我們先把孩子的體溫退下來，讓小孩安靜，盡量減少他的一些痛苦。同時，我們也在給他進(jìn)行病因治療。您的孩子有先天性心臟病，抗病能力差一些。

患兒媽媽：現(xiàn)在小孩不停地咳嗽，還喘呢，這也與“先心”有關(guān)？ (語氣開始緩和)

護(hù)士：是這樣的，“先心”的孩子抵抗力相對較差。有的發(fā)育落后于其他孩子，一旦受涼或被感染易并發(fā)肺部感染，而肺部感染又會加重心臟癥狀。這次您的孩子就是合并了支氣管肺炎。針對孩子的氣喘與咳嗽我們已經(jīng)對癥處理了，如：氧噴，霧化，還有靜脈用藥。但發(fā)揮明顯的作用要有個過程的。在治療過程中，為了取得更好、更快的療效，希望你們盡可能配合和支持我們的工作?？人?、有痰，經(jīng)常給孩子翻身拍背，多給孩子喝水，有助于痰液排出。

患兒媽媽：真的呀，能教我嗎？

護(hù)士：這樣拍 (護(hù)士做示范)

患兒媽媽：這個樣子對嗎？(為患兒翻身拍背)

護(hù)士：對的，但是應(yīng)注意將手拱成空心狀 (再次做示范)(孩子仍然哭吵)

Interactions

Patient’s Mother: You only say the things we like to hear. So far we have spent more than $1,000 yuan, but the baby’s fever is still the same. He cries and screams non-stop. It is not getting any better at all. It must be due to the poor treatment and medicine you gave him. Where is the doctor? I want to see him.

Nurse: I am just about to ask the doctor to come to have a look on your baby. Please wait a moment. I will call him at once. (After examining the baby, the doctor prescribed medicines to lower the baby’s temperature. The doctor also ordered an enema for him.)

Nurse: After examined your baby, the doctor has prescribed the new antipyretic drug for him. I will give him the medicine and then wipe his body with warm water. His body temperature should go down shortly. The baby will quiet down after I give him the enema.

Patient’s Mother: You always give him medicine when his temperature is high and apply enema when he cries. But his symptoms have recurred again and again. Don’t you have other methods to treat him?

Nurse: Feng-Feng’s mom, I am sorry for letting you worry. We first need to reduce the baby’s temperature to quiet him down, and then alleviate his discomfort. At the same time, we are treating the cause of his disease. Your baby has a congenital heart disease and his immunity to diseases is low.

Patient’s Mother: The child coughs endlessly and breathes heavily. Are these all related to his congenital heart disease too? (Her tone begins to relax.)

Nurse: Yes. A child with congenital heart disease has relatively poor immunity and may be slower in his overall development than healthy children. It is easy for him to develop a lung infection when suffering from colds, and a lung infection can aggravate his heart problem. This is what your baby has, a complicated bronchus pneumonia. We have treated his symptoms with oxygen inhalation, aerosol spray, and intravenous medicines. But, it takes time to recover. In the course of the treatment, in order to obtain better and faster results, I hope you would cooperate with us and support our work. Your baby has cough with sputum. Turn him, pat his back, and provide water for him to drink. This will help him to cough up the sputum.

Patient’s Mother: Really? Could you teach me how to pat him?

Nurse: Pat him like this. (The nurse demonstrated)

Patient’s Mother: Is this right? (Turned over the baby and patted his back)

Nurse: Right, but make your hand into a hollow form (Demonstrated again) (the child still cries)

(曾梅鳳)