- 期刊
協助一位尿毒症患者由腹膜透析轉作血液透析治療之護理經驗
The Nursing Experience of Taking Care of a Uremic Patient Shifting from Peritoneal Dialysis to Hemodialysis
摘要
本篇旨在探討協助一位尿毒症患者由腹膜透析轉作血液透析之護理經驗。護理期間為2009年9月4日至11月4日，藉由會談、觀察、身體評估及查閱病歷方式收集資料，運用Gordon十一項健康功能型態進行評估，確立個案之主要護理問題為：焦慮、急性疼痛和無效性健康維護能力。經由筆者提供個案個別性的護理指導，澄清不同透析治療方式日常生活照護的差異性，並教導新建瘻管通路之照護措施強化瘻管功能，適時鼓勵個案表達感受及澄清疑慮，增進個案對血液透析治療之疾病認知，運用關懷、同理心、陪伴及支持技巧，合併音樂療法，降低個案之焦慮情緒。主動以藥物及非藥物止痛措施以減輕其動靜脈瘻管術後的疼痛問題。善用社會支持系統及專業溝通技巧，增進個案學習之自我照顧行為，協助個案渡過轉換治療的適應過程及正向的態度面對疾病。期望此護理經驗能提供透析護理人員照護此類病患之參考。
並列摘要
This article discusses the nursing care experience of a uremic patient during the transition from peritonitis to hemodialysis due to repeated peritonitis. Gordon's 11-item Function Health Pattern Evaluation was used to assess the patient's needs during observation, interview, physical examination, treatment, and medical record review. The patient's health problems included anxiety, acute pain, and ineffective coping. The individualized nursing care included clarification of the daily care regimes, educating the care and strengthening the function of the newly placed A-V shunt, encouraging the patient to express feelings, being empathetic and supportive, music therapy, and use of analgesic and non-analgesic post-op pain management interventions. Use of a professional social support system improved the patient's self-care behavior and positive outlook.
延伸閱讀
- 林育珊、林嘉鈴（2015）。一位自腹膜透析轉換成血液透析病人之護理經驗。臺灣腎臟護理學會雜誌，14(2)，28-37。https://doi.org/10.3966/172674042015061402003
- 張宜驊（2014）。照護一位因腹膜透析導致腹膜炎轉血液透析病患之護理經驗。彰化護理，21(1)，41-49。https://doi.org/10.6647/CN.21.01.15
- 陳鳳裕（2007）。協助一位慢性腎衰竭患者接受血液透析治療之護理經驗。嘉基護理，7(2)，16-24。https://doi.org/10.29936/DMFCCHJN.200711.0003
- 邱美靜、周佩君（2021）。運用自我管理策略協助一位初次血液透析病人轉腹膜透析治療之護理經驗。台大護理雜誌，17(1)，78-89。https://doi.org/10.6740/NTUHJN.202101_17(1).0008
- 彭碧慧、黃秀梨（2010）。A Nursing Experience for a Patient Receiving Peritoneal Dialysis。領導護理，11(2)，43-53。https://doi.org/10.29494/LN.201008.0006