一位K他命膀胱炎個案之手術全期護理

本文是描述一位二十四歲女性，吸食K他命引發K他命膀胱炎併膀胱萎縮，行腸道膀胱擴大手術全期護理經驗。護理期間為西元2011年11月19日至12月06日，以Gordon十一項功能性健康評估，運用觀察、會談、身體評估及電話聯絡方式收集資料，確認問題有焦慮、情境低自尊、潛在危險性手術情境傷害、個人因應能力失調。術前運用照片衛教本及陪伴觀看手術影片，降低術前焦慮；此外衛教手術將膀胱容量增大可改善頻尿及包尿布情形，進而降低情境低自尊。手術當天更加留意床單的平整，預防此手術長時間所造成身體傷害。術後更協同個案面對壓力來源，進而增加問題解決的能力並戒斷K他命。期盼藉由此經驗分享提供日後照護類似個案之參考。

關鍵字

K他命；腸道膀胱擴大整形術；手術全期護理

並列摘要

This case report addresses the perioperative nursing experience of a 24-year-old girl who, suffering from Ketamine cystitis complicated with bladder contraction, was admitted for augmentation enterocystoplasty. The nursing period was from 19th, Nov. to 6th Dec, 2011. The patient's problems were assessed based on Gordon's 11 functional health patterns, and four major issues were identified: preoperative anxiety, low self-esteem, fear of potential surgical risks and poor stress coping skills. In response to the patient anxiety, patient-information brochure and video were implied to orientate patient about settings in operating room and surgical procedures. In addition, in order to reduce the situational low self-esteem, health education was conducted to educate the patient that surgery could improve urinary frequency and reduce diaper usage. On the day of surgery, the operating table was set up attentively to minimize patient's physical discomfort from long surgical duration. The team would also accompany the patient during the postoperative phase to identify stressors leading to ketamine addiction, as well as to acquire problem-solving skills and ultimately quit Ketamine. This case report may serve as a reference for future nursing staffs when caring similar cases.

並列關鍵字

augemtnation enterocystoplasty ； Ketamine ； perioperative nursing

國際替代計量

一位K他命膀胱炎個案之手術全期護理

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