照護一位血液透析病患人工血管反覆阻塞之護理經驗

Nursing Experience of Caring a Hemodialysis Patient with Arteriovenous Fistula Occlusion Repeatedly

李麗娟(Li-Chuan Lee) ； 盧惠敏(Hui-Ming Lu) ； 楊素真(Su-Chen Yang)

《亞東學報》 32期 (2012/12) Pp. 211-221

https://doi.org/10.30167/JOIT.201212.0009

摘要

本文是探討一位血液透析病患多次人工血管阻塞之護理經驗，護理期間自2010年7月26日至9月15日。筆者以Gordon十一項功能性健康型態評估，藉由觀察、會談、傾聽與直接護理等方式收集資料，確立個案有無效性自我健康管理、體液容積過量、無望感之健康問題。在照護過程中，藉由主動關懷深入瞭解個案在執行血管照護上所遇到的問題與困難，提供相關訊息及製作專屬血管照護手冊與海報，增進認知學習確實執行人工血管自我照顧；另評估其飲食習慣，提供個別性的限水限鹽措施與護理指導，適時給予口頭讚美與肯定，增進其學習動機，漸進式達到理想的水分控制；建立良好的信賴關係，引導表達內心的想法與感受，藉由社會支持系統來鼓勵其參加相關的社交活動，提升自我存在價值，以積極正向的態度面對透析治療，更進一步提升生活品質。

關鍵字

人工血管阻塞 ； 自我管理 ； 體液容積過量 ； 無望感

並列摘要

This article is to share a nursing experience of caring a hemodialysis patient with repeated occlusion of arteriovenous fistula between July 25 to September 14, 2009. Gordon's 11 Functional Health Patterns was used to evaluate patient condition and data were collected by observation, interviews, listening and personal nursing care. The health problems of this patient were poor self-health management, volume overload, and hopelessness .In the nursing process, the patient was actively approached to understand deeply about the difficulties and problems encountered in the fistula care. By doing so, the author offered related information, exclusive fistula caring manual and poster to promote patient awareness and facilitate fistula self-care. Besides, by evaluating the intake pattern, the author provided individualized nutritional advices about sodium and water restriction and nursing guide. When weight control was improved, the author would give him praise and recognition which was supposed to increase his learning motivation leading the patient to the ideal fluid control status gradually. A good relationship of trust between the author and the patient was established which could lead the patient to share feeling and thoughts with the author. By the social support system to encourage his participation in social activities to enhance the value of self-existence, and a positive attitude towards the dialysis treatment, and further improve the quality of life.

並列關鍵字

Arteriovenous fistula occlusion ； Self-health management ； Fluid overload ； Hopelessness

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