單側全膝關節置換術之護理經驗

本篇旨在描述一位65歲病人因長期退化性關節炎要接受單側全膝關節置換術之護理經驗，護理期間為2008年06月07日至16日，運用Gordon十一項功能性健康型態做為評估架構，與病人互動過程中透過觀察、傾聽、會談及溝通等技巧收集資料，經歸納分析出病人有：焦慮、急性疼痛、潛在性感染、身體活動功能障礙等健康問題。藉由手術前主動關懷陪伴及一對一的護理指導說明手術過程；協助手術後立即使用冰敷止痛及引導深呼吸放鬆技巧；每日至少一次管路護理及監測引流量；與病人討論復健運動進度，依計畫採漸進式的下床活動等護理措施介入後，結果使病人焦慮程度改善增加對手術的信心；手術後急性疼痛評估由9分降至3分；手術後第3日順利拔除身體上留置的管路；並促進肌肉關節的活動度，逐漸恢復日常生活功能，早日康復面對未來的生活。

關鍵字

全膝關節置換術；急性疼痛；身體活動功能障礙

並列摘要

This report describes the experiences when nursing a 65 year old female who had suffered from degenerative arthritis and had received unilateral total knee replacement surgery. This covered the period from June 07 2008 to June 16 2008. The author adopted the Gordon's eleven functionalities to collect the data by observation, listening, and communicating with the patient. The results showed that the patient had several nursing concerns including feel anxious, acute pain, the possibility of latent infection and physical dysfunction. By actively showing interest in the patient, being empathetic to the patient, providing nursing care and introducing the process of surgery step by step, the author helped the patient gain confidence. After operation the pain was resolved by using ice compresses immediately and by deep breathing. In addition, the amount of drainage and the catheter was monitored at least once ever day. Treatment with physical therapy helped to induce the patient to use a walker early on and to get out the bed. This helped the patient to improve in confidence and also helped to decrease the pain. All tubes were removed quickly, which help mobility and this, in turn, strengthened the patient's muscle power. This allowed recovery of daily activity as soon as possible and helped the patient begin her future life.

並列關鍵字

total knee replacement ； acute pain ； physical dysfunction

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單側全膝關節置換術之護理經驗

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