- 期刊
- OpenAccess
照顧一位惡性直腸腫瘤低前手術後的護理經驗
The Experience of Nursing Care for a Patient with Mailgnant Rectal Tumor after Lower Anterior Resection Surgery
摘要
本文描述一位行惡性直腸腫瘤低前位手術的護理經驗，護理期間2020年12月18日至2020年12月28日，藉由病歷查閱、觀察、訪談與運用Gordon十一項功能性健康型態評估，確立健康問題有急性疼痛、高危險性感染、營養狀況改變及焦慮。照顧期間運用疼痛評估量表來評估術後疼痛情形，並提供疼痛控制及放鬆技巧；術後每日評估傷口，依嚴格無菌標準技術換藥，以預防傷口感染，使儘早移除管路；為改善個案營養狀態，並給予適當的飲食指導；在心理方面個案面臨手術所造成負面心理衝擊，為減輕病患焦慮，給予術前解說及運用同理心建立良好的護病關係，鼓勵家屬陪伴，共同克服手術所帶來的衝擊，使個案能儘早回歸日常生活。期望藉此照護經驗，將學理知識與臨床實務結合，增進自我照護能力及信心，並供臨床護理人員之參考。
並列摘要
This article describes the nursing experience of caring for a patient with malignant rectal tumor who received lower anterior resection surgery. The period of care was from December 18 to December 28 in 2020. Data were collected through medical record review, observation and interviews and Gordon's 11 functional health patterns were applied for assessment. The health problems identified were acute pain, high-risk infection, change in nutritional status and anxiety. During the nursing period, pain assessment scale was used for the assessment of postoperative pain, and pain control and relaxation techniques were provided; the wound healing condition was evaluated every day after the surgery, and dressing was performed in accordance with standard aseptic technique strictly to avoid infection so as to enable tube removal as soon as possible. To improve the nutritional status, appropriate dietary guidance was given to the patient. Psychologically, the patient faced negative psychological impacts caused by surgery, and to alleviate the patient's anxiety, preoperative explanation was given, and empathy was expressed to establish a good nurse-patient relationship. The family members were also encouraged to accompany the patient to overcome the impact of the surgery so that the patient could return to the normal life as soon as possible. It is hoped that through this care experience, the academic knowledge can be combined with clinical practice to improve self-care ability and confidence, and that the experience can serve as a reference for clinical nursing staff.
參考文獻
延伸閱讀
- 鄭棋芮、柯幸芳（2020）。照護一位結直腸癌術後併發周邊動脈阻塞之病人護理經驗。長庚護理，31(4)，582-592。https://doi.org/10.6386/CGN.202012_31(4).0011
- 陳國莉（2010）。照顧一位直腸癌患者行腹腔鏡腹部會陰切除術之手術全期護理經驗。彰化護理，17(1)，6-17。https://doi.org/10.6647/CN.17.01.05
- 張雅芳（2018）。照護一位腹腔鏡直腸癌切除併行迴腸造口個案手術全期之護理經驗。領導護理，19(4)，57-72。https://doi.org/10.29494/LN.201812_19(4).0005
- 馮湘婷、李佳倫（2015）。一位初診斷直腸癌行腸造口術病人之護理經驗。安泰醫護雜誌，21(1)，1-11。https://www.airitilibrary.com/Article/Detail?DocID=18111955-201506-201508110005-201508110005-1-11
- 蕭書意、蘇淑女（2019）。Nursing Experience of a Patient with Intrahepatic Cholangiocarcinoma Surgery。彰化護理，26(3)，38-48。https://doi.org/10.6647/CN.201909_26(3).0007