- 期刊
一位抗嗜中性球細胞質抗體血管炎合併腎臟侵犯病人接受血液透析及血漿置換術之照護經驗
The Experience of Caring for a Patient with Antineutrophil Cytoplasmic Antibody Vasculitis and Renal Involvement who Underwent Hemodialysis and Plasmareplacement
摘要
本文描述一位抗嗜中性球細胞質抗體（antineutrophil cytoplasmic antibody, ANCA）血管炎的個案，因腎臟遭受侵犯導致病人必須接受血液透析及血漿置換術的住院照護經驗。筆者於102年6月15日至102年6月29日護理期間，以會談、身體評估、實際照護及病歷查閱等方式收集資料，並運用Gordon十一項功能性健康型態評估進行整體性評估，歸納病人主要護理問題為：體液容積過量、潛在危險性感染及焦慮等健康問題。護理過程中護理人員運用主動關懷、傾聽及同理心，給予個案及家屬心理支持與鼓勵，陪伴渡過疾病的急性期；亦提供個別性護理措施以加強限水、飲食衛教及血液透析治療，矯正其對疾病錯誤認知，鼓勵個案及家屬共同學習相關技能以提昇疾病照護知識及導管照護之技巧，協助其正向態度面對疾病、適應透析後的生活及重建自信。期望藉由此護理經驗，提供臨床護理同仁在照護此類病人之參考。
並列摘要
This article describes the caring experience of a patient with ANCA vasculitis, who was hospitalized for receiving hemodialysis and plasma replacement owing to kidney involvement. The nursing care period ranged from June 15 to June 29, 2013. Data was collected through interview, physical evaluation, direct care and medical record review. Via an overall assessment based on Gordon’s 11 functional health patterns, it is concluded that the major nursing issues of this patient are fluid volume excess, risk for infection and anxiety. During the nursing period, the nurses assisted the patient and his family to get through the acute stage of the disease by providing psychological support and encouragement with proactive caring, listening, and empathy. Individual nursing measures were also implemented to strengthen water limitation, nutritional education and hemodialysis treatment, correct misconception towards the disease, and encourage the patient and his family to learn relevant skills together for enhancing knowledge on disease care and catheter care techniques, so as to help the patient to face the disease positively, adapt to post-dialysis life and re-build self-confidence. By sharing this experience, it is hoped that nurses can use the article as resource and gain insight into caring for similar patients in the future.