- 期刊
一位腎細胞癌病人術後併發肺栓塞與出血合併症之照護經驗
Nursing Care for a Patient with Renal Cell Carcinoma Complicated with Postoperative Pulmonary Embolism
摘要
本文描述一位腎細胞癌病人於術後併發肺栓塞與出血合併症之護理經驗。護理期間自2018年1月31日至2月14日，藉由直接照護、會談、傾聽及觀察等技巧收集資料，並以Gordon十一項功能性健康型態評估，確認病人有氣體交換障礙、急性疼痛及高危險性損傷等三個主要健康問題。照護期間依病情變化進展，提供抗凝血劑、維持氧合及氣體交換等護理照護，有效改善病人的呼吸困難；予調整用藥及減輕疼痛照護，疼痛由9分下降至1分；因使用抗凝血劑引起出血副作用予預防出血照護，未新增出血徵象且無損傷發生。同時，發現病人於疾病病程伴隨焦慮情緒，可藉由跨領域團隊人員共同參與討論及照護，提供關懷及治療相關訊息，促進病人恢復身心健康。期待未來各家醫院能制訂肺栓塞照護標準及護理指導單張，提供護理人員遵循及協助病人面對疾病變化所產生的生理與心理衝擊，藉以提升護理照護品質。
並列摘要
This study describes nursing care provided for a patient with renal cell carcinoma complicated with postoperative pulmonary embolism and hemorrhage. The nursing period was from January 31 to February 14, 2018. This study used approaches such as direct care, interviews, and observation to collect data. Gordon's 11 Functional Health Patterns Assessment was used to confirm that the patient suffered from three major health issues: impaired gas exchange, acute pain, and high-risk injury. During the care period, the patient received emergency and individual nursing care according to disease progression to effectively improve dyspnea. The pain score decreased from 9 points to 1 point, and the patient did not experience new signs of hemorrhage or injury. During this study, moreover, the patient experienced anxiety as the disease progressed. The recovery of patients' physical and psychological health is believed to benefit from timely care and access to treatment-related information. Health education leaflets on pulmonary embolism might help patients and their families to recover from the physical and mental shock caused by disease progression and improve nursing care quality.