照顧一位腎動脈瘤破裂接受根除性全腎手術病人之護理經驗

本文旨在分享一位長期接受腎臟透析年輕女性個案，因腎動脈瘤破裂接受根除性全腎切除之照護經驗，照護期間為2019年5月11日至6月20日，藉由會談、觀察、身體評估及病歷查閱等方式收集資料，發現個案有感染、焦慮及疼痛護理問題，個案手術後因急性疼痛加上對未來的生活不確定產生焦慮等負向情況。筆者於照護期間利用物理性方式及輔助藥物治療，緩解個案因感染造成發燒的不適感，並投其所好轉移個案對疼痛注意力，連結醫療團隊各職類專長提供腎臟手術的相關照護資訊，並說明疾病治療計畫以減輕其焦慮感。期盼藉由此案例能提供國內因腎動脈瘤破裂所引起相關合併症及心理變化之參考依據。

關鍵字

根除性全腎切除手術；腎動脈瘤；疼痛；焦慮

並列摘要

This case report described the nursing care experience of a young female patient with ruptured renal artery aneurysms who received total nephrectomy and developed medical complications of abdominal cavity hematoma. The nursing period of care was from May 11 to June 20, 2019. Through in-depth interviews, observations, physical examinations for assessments, and retrospective investigation on medical records, major health problems were identified, and including: infection, anxiety, and acute pain. During the nursing process, both pharmacological non-pharmacological interventions were provided to relieve discomfort originated from infection and fever; the patient was taught how to focus on her interests to distract from pain. training in order to enhance activity tolerance. In addition, multi-disciplinary teamwork was referred to provide individualized consultation. Other nursing care included total nephrectomy relative information, possible complications responses, active listening and company in order to alleviate feelings of uncertainty, etc. Such individualized care has resulted in patient's decreased pain, alleviated anxiety, and a positive attitude toward the operation.

並列關鍵字

Total nephrectomy ； renal artery aneurysms ； pain ； anxiety

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