照顧一位血液透析病患接受髖關節置換術後之護理經驗

The Experience to Nurse a Hemodialysis Patient with Hip Replacement Operation

黃瑞華(Jui-Hua Huang)

《臺灣腎臟護理學會雜誌》 5卷2期 (2006/12) Pp. 80-91

摘要

本研究個案取樣自某區域教學醫院血液透析室曾接受關節置換術之患者，照護期間為94年10月20日至11月30日。運用Gordon十一項健康功能型態模式、會談觀察、身體評估及二次電訪家訪，評估個案有體液容積過量、組織灌流改變、身體活動功能障礙、潛在危險性跌倒、潛在危險性周邊神經血管功能障礙與無力感等六項護理問題。經介入護理計畫後，個案與其家屬能辨識高磷、高鉀食品，個案可執行水分控制、瘻管照護與復健運動、自我判別異常徵狀與術復禁忌姿勢、建立安全居家環境並正確使用助行器，並參與病友團體活動等。作者以功能性健康型態模式，研擬此類個案的護理措施，提升個案及家屬對疾病的認知及自我照顧能力，進而改善術後生活品質。

關鍵字

血液透析 ； 髖關節置換術 ； 功能性健康型態

並列摘要

The patient in this case study was selected from a hemodialysis center of certain regional teaching hospital, who accepted hip replacement operation and was nursed between 20(superscript th) Oct. to 30(superscript th) Nov. 2005. Then the author used Gordon 11-item functional health pattern assessment guide, observation at interviews, physical examination and twice follow-up telephone interview and family visit to assess the patient's conditions and find that the patient's suffered with six main health problems, the body fluid volume excess, the tissue perfusion altered, physical mobility impaired, potential risk of tumble, potential danger of peripheral neuro-vascular dysfunction and powerlessness. After interventional nursing plan, the patient and her family could tell high potassium from high phosphate food, the patient also could control fluid ingestion, take care of her fistula and get exercise for rehabilitation, sense abnormal symptom by herself and prevent forbidden gestures after operation, build up safe habitation environment, use walker correctly and take part in group activities with other patients. The author based on the functional health-pattern to work out nursing measures for such case, and step up her cognition for the disease and self-care ability as so to improve her life quality after operation.

並列關鍵字

hemodialysis ； hip replacement ； functional health pattern