應用Orem理論照護一位急診肝性腹水病人之經驗

Emergency Care of a Cirrhotic Patient Using Orem's Theory

邱倩卉(Chien-Hui Chiu) ； 薛琬萱(Wan-Hsuan Hsuen)

《馬偕護理雜誌》 6卷1期 (2012/01) Pp. 82-90

https://doi.org/10.29415/JMKN.201201_6(1).0008

摘要

本文為照護一位B型肝炎帶原合併肝硬化病人之急診護理經驗，個案自2003年診斷出肝硬化，此次併發腹水導致呼吸困難，首次行腹水放液術，照護期間自2009年2月17（17:30）至2009年2月17日（22:30），筆者主要以會談、身體評估及病歷查閱等方式收集資料，依歐倫自我照顧理論進行護理評估及擬定適切、立即性護理措施。照護期間確立個案有體液容積過量、焦慮、健康尋求行為之護理問題，利用衛教單張說明疾病相關知識與腹腔放液術過程及透過建立治療性人際關係，主動關懷適時陪伴並鼓勵表達自身感受，以減輕治療前焦慮不安，給予日常生活照顧衛教，使其以正向態度面對問題，預防合併症發生，增進返家後自我照顧能力，進而提升生活品質。

關鍵字

肝性腹水 ； 焦慮 ； 日常生活照顧 ； 歐倫自我照顧理論

並列摘要

A patient who had been diagnosed 6 years previously with liver cirrhosis secondary to hepatitis B came to the Emergency Room in respiratory distress caused by ascites. The author cared for the patient for 5 hours as he was admitted for therapeutic paracentesis. The nursing assessment included interviewing the patient, physical examination, and chart review, with data collected based on Orem's self theory. The following problems were identified: fluid overload, anxiety, and health-seeking behavior. The author established a therapeutic interpersonal relationship with the patient to provide active care, to remain with the patient, and to encourage him to express his feelings. Specific, appropriate nursing measures involved explaining the condition and the paracentesis procedures in order to reduce the patient's anxiety. In addition, health education was provided to promote the patient's ability for self-care and to prevent further complications.

並列關鍵字

cirrhosis ascites ； anxiety ； daily care ； Orem's self theory