一位血液透析病人罹患周邊動脈阻塞疾病併發截肢之護理經驗

A Nursing Experience of a Hemodialysis Patient with Peripheral Arterial Occlusive Disease Complicated with Amputation

李子瑜(Zih-Yu Li) ； 林嘉慧(Chia-Hui Lin) ； 黃羿華(Yi-Hua Huang)

《臺灣腎臟護理學會雜誌》 22卷1期 (2023/12) Pp. 42-55

https://doi.org/10.53106/172674042023122201004

摘要

本文敘述一位血液透析個案合併周邊動脈阻塞疾病導致傷口惡化面臨左膝下截肢，截肢後的外觀及結構改變，造成其心理巨大的衝擊與震撼。護理期間於2021年4月8日至2021年6月30日，運用Gordon十一項健康功能型態進行整體評估，藉由會談、護理、觀察及傾聽技巧收集資料，確立個案有營養不均衡：少於身體需要、身體活動功能障礙及身體心像紊亂之健康問題。照護期間利用蛋白質替換食譜QR code，採循序漸進的飲食計畫改善營養狀態，教導家屬截肢後產生的身體功能障礙和負面情緒之照護技巧，運用主動關懷、陪伴、引導其表達內心感受、鼓勵家人參與陪伴支持。照顧截肢病人在面對此段挫敗的人生經歷，醫療人員應積極協助面對不可逆的合併症，並提升其自我照護知識與能力，重建正向態度找回自我控制權迎向新生活。

關鍵字

血液透析 ； 周邊動脈阻塞疾病 ； 截肢

並列摘要

This article describes the nursing experience of a hemodialysis patient with PAOD receiving below-knee amputation. The appearance and structural changes of the amputated limb had a huge psychological impact and shock. The nursing period was from April 8 to June 30, 2021, using Gordon's 11 Functional Health Patterns were to collect information through direct care, observation, medical records and interviews. Identified problems included inadequate nutrition, impaired physical mobility and body image disturbance. During the nursing process, provided individualized nursing, designed protein exchange recipe guided by QR code, monitored his nutritional status and taught his family after amputation care skill. The author performed active caring and accompanied him to guide him express his deep mind feelings and to encourage his family to give support and accompany. Medical professionals should actively help amputees face irreversible complications, enhance their knowledge and self-care skills, rebuild positive attitudes, regain self-control and move forward to a new life.

並列關鍵字

emodialysis ； peripheral arterial occlusive disease ； amputation

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