一位再次接受膀胱腫瘤切除病患手術全期護理

本文係探討一位再次接受經尿道內視鏡膀胱腫瘤切除術之手術全期護理經驗。個案面對罹患膀胱腫瘤再次手術的不確定感仍顯焦慮不安。筆者於2010年1月19日至2010年1月25日護理期間，藉由持續性的會談、觀察及應用Orem理論進行評估，並以手術全期照護模式為基礎。發現個案的健康問題有「手術前期：焦慮」、「手術中期：體溫過低、潛在危險性手術期間擺位之傷害」、「手術後期：睡眠型態紊亂」等。在照護過程中，針對個案術前的需求提供支持教育性護理措施，增加個案對手術的認知及因應能力、減輕焦慮，使其有信心的再接受手術；手術中期因麻醉自我照顧能力缺失提供完全代償性護理；術後症狀穩定自我照顧能力恢復，提供部分代償性護理；待出院做準備時又提供支持與教育性護理，促進其日後自我照顧能力，藉此提升護理服務品質，使個案獲得連續性及整體性照護。

關鍵字

經尿道內視鏡膀胱腫瘤切除術；手術全期護理； Orem理論

並列摘要

The case report was to describe the perioperative nursing experience in caring a patient who accepted re-operated the transurethral resection of bladder tumor. The nursing process was from 19 January to 25 January in 2010. By the utilization of the perioperative nursing care model as foundation method, the author applied interview, observation and Orem’s theory to evaluate this patient. The result of the perioperative nursing care found that the patient felt anxious and uncertain to retake the surgery. The patient health problems revealed that: at preoperative phase – Anxiety; at intraoperative phase – Hypothermia and risk for injury from the operation; at postoperative phase – Sleep pattern disturbance. During the perioperative nursing period, the author provided the comprehensive perioperative nursing skills such as strong supports, educational nursing before the surgery in order to improve the knowledge of surgery to alleviate nerves and help patient to have self-confidence. At the intraoperative phase, offering a complete compensatory nursing to help patient recover from anesthesia. At the postoperative phase, offering a partly compensatory nursing to teach patient self care. Whilst patient leaves hospital, providing and supporting the educational nursing to make sure that patient has ability of self care. It will evaluate nursing service quality and help patient to acquire more nursing care.

並列關鍵字

Transurethral resection of bladder tumor ； perioperative nursing ； Orem's Theory

國際替代計量

一位再次接受膀胱腫瘤切除病患手術全期護理

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