協助一位慢性腎病變患者適應疾病過程之護理經驗

Assisting a Patient in the Adaptation of Chronic Kidney Disease

趙麗玫(Li-Mei Chao) ； 鄭玉華(Yu-Hua Cheng)

《源遠護理》 3卷2期 (2009/11) Pp. 46-55

https://doi.org/10.6530/YYN.2009.3(2).06

摘要

本篇報告為協助一位慢性腎病變患者在加護病房期間適應疾病的護理過程，護理期間為2006年8月15日至2006年8月25日止，期間運用觀察、會談、傾聽、及檢閱病歷等方式收集資料，並以羅氏適應模式進行整體性評估及分析，發現個案主要護理問題有體液容積過量、營養狀況不平衡及無力感。透過教導水份控制觀念及飲食的注意事項與安排血液透析，緩解體液容積過量現象，進而維持適當的氣體交換、改善呼吸狀況；協助採漸進式鼻胃管滴注灌食，逐步增加灌食量與建立少量多餐的飲食型態，而改善熱量攝取不足之營養問題，並藉由筆者多次主動關懷給予心理支持、提供血液透析相關知識及加強自我照顧能力，且透過腎友經驗分享，幫助個案面對疾病所帶來之不適與無力感，使其能改變對疾病認知並逐漸適應日後長期血液透析治療。

關鍵字

慢性腎病變 ； 羅氏適應模式 ； 無力感

並列摘要

This report describes the nursing process of a patient with chronic kidney disease (CKD) by Roy's Adaptation Model during the staying in the intensive care unit. The patient's major problems included excess fluid volume, imbalanced nutrition and sense of powerlessness. Hemodialysis treatment resolved the patient's excess fluid volume and improved the respiratory status and the gradual increase of feeding amount via nasogastric tube improved the patient's imbalanced nutrition. Patient education focused on fluid and diet adjustment. Caring psychological support and knowledge gained on hemodialysis enhanced the patient's self-care ability. The sharing through a kidney disease support group helped the patient face his disease. The nursing care based on Roy's Adaptation Model demonstrated effectiveness in helping patient with CKD to adapt and manage his long-term need for hemodialysis.

並列關鍵字

chronic kidney disease CKD ； Roy's Adaptation Model ； powerlessness