一位使用ketamine致排尿障礙及因應能力失調之護理經驗

Nursing Care Experience of a Ketamine User with Voiding Dysfunction and Response Capacity Disorders

張瑜芳(Yu-Fang Chang) ； 黃復蓉(Fu-Jung Huang)

《馬偕護理雜誌》 12卷1期 (2018/01) Pp. 37-47

https://doi.org/10.29415/JMKN.201801_12(1).0003

摘要

本文是描述一位33歲女性，因吸食ketamine致排尿困難患者，於住院期間引發生理及心理相關健康問題的護理經驗，照護期間為於2014年4月23日至6月10日，運用會談、觀察、身體評估及電訪方式收集資料，筆者以Gordon十一項功能性健康型態評估為架構，經彙整分析後，確定個案有疼痛、排尿型態障礙及個人因應能力失調等健康問題，針對個案健康問題提供適當護理措施，包括藉由放鬆、轉移注意力、束腹帶使用緩解疼痛，同時衛教凱格爾運動及預防泌尿道感染方式，以漸進改善排尿障礙。過程中運用同理心引導個案表達內心感受，藉由良好的支持系統予陪伴、鼓勵，引導抒發負面情緒，建議可增強自信心以堅定戒毒決心。期望藉此護理經驗能提供護理同仁在照顧藥癮病患時，能以同理心照顧病患，達個別照護，並協助建立自信與自尊，以避免患者再次使用ketamine，能重新回歸社會正常生活。

關鍵字

ketamine ； 排尿功能障礙 ； 因應能力失調

並列摘要

This paper described the nursing experience of a 33-year-old female with ketamine-related difficult urination, had physical health and psychological problems during hospitalization from April 23, 2014 to May 26, 2014. Collection methods of patient information were face to face communication, observation, physical assessment and telephone interviews. The data was collected and analyzed by Gordon eleven functional assessment framework, and the health problems were determined by pain, patterns of urinary obstruction and personal response capability disorders. The appropriate care methods included relaxation, distraction, corset belt use for pain relief, improvement of dysuria by Kegel exercise education and prevention of urinary tract infection. A good support system could accompany, encourage and guide the expression of negative emotions. We recommended building up the self-confidence and abstinence of drugs resolution. We expected this nursing care experience could assistant nursing staffs in taking care of patients with drug addiction and builiding up patients' self-confidence and self-esteem. This experience could avoid the patients using ketamine again and let them return to normal social life.

並列關鍵字

ketamine ； voiding dysfunction ； response capability disorders