照護一位胰腎移植病患術後之護理經驗

The Nursing Experience of Postoperative Care of a Simultaneous Pancreas and Kidney Transplantation Patient

謝菁怡(Ching-Yi Hseh) ； 許莉宛(Li-Wan Hsu)

《高雄護理雜誌》 35卷2期 (2018/08) Pp. 104-115

https://doi.org/10.6692/KJN.201808_35(2).0010

摘要

本文描述一位罹患第一型糖尿病併末期腎臟疾病而長期洗腎之病患，經胰腎器官移植術後之護理經驗，照護時間為2016年8月9日至8月18日。筆者藉觀察、會談、身體評估等方式，運用Gordon十一項功能性健康模式做整體性評估，確立個案有體液容積過量、焦慮、知識缺失和潛在危險性感染等健康問題。針對健康問題擬定護理措施，持續提供移植術後自我照護訊息，協助個案了解如何攝取適合身體需求的飲食、改善水腫方法、及預防感染等措施、及幫助個案能面對移植後疾病變化的不確定感及返家後的自我照護等問題，能早日恢復自我照顧能力，以提升術後居家生活品質，期許此護理經驗可提供護理人員日後照顧此類病患，有相關資訊可參考。

關鍵字

胰腎移植 ； 移植術後照護 ； 焦慮

並列摘要

This article describes a post-operative nursing experience in caring for a Type I Diabetes patient with End Stage Renal Disease under long-term hemodialysis after receiving a double simultaneous pancreas and kidney transplant. The period of nursing care was from August 9 to August 18, 2016. Gordon 11 healthy function patterns as an assessment tool were used, and information was collected through interviews, observations, attentive listening and physical examinations. Three health issues were identified：＂fluid volume excess＂, ＂anxiety＂, ＂knowledge deficiency＂ and ＂risk of infection＂. The nursing plan was made for the patient’s health problems, and provided self-caring information after transplantation. Following the plan, the patient could not only know how to make the diet balance, improve body edema, and prevent infection, but also deal with the uncertainty after transplantation and home self-caring. Therefore, the patient could receive ability of self-caring in a timely manner and make life quality better. Hopefully, the nursing experience could be a reference for nursing staff and patients in the future.

並列關鍵字

simultaneous pancreas and kidney transplantation ； post-transplant care ； anxiety

參考文獻

王菁莞、林佑樺、李來涼、簡婉儀、陸椿梅(2014)．探討多媒體護理指導對婦科開腹手術病人術前焦慮之成效．護理暨健康照護研究，10(3)，169-177。

白玉玲、丘周萍(2011)．血液透析患者體液容積過量的照護．源遠護理，5(1)，5-10。

周桂君、李明哲(2014)．腎臟移植的醫療照體現況．護理雜誌， 61(4)，15-20。

周桂君、李明哲、蔡娟秀(2016)．糖尿病患者之腎臟移植．腎臟與透析，28(2)，72-75。

洪啟峰、楊晨洸、徐國雄、賀昊中(2016)．腎臟移植術後之手術併發症．腎臟與透析，28(1)，27-30。