本文為探討一位血液透析病人因體液容積過量,造成生、心理衝擊之護理經驗。筆者於2017/11/20至2018/2/4,採觀察、會談等方式,以Gordon十一項健康功能型態評估,蒐集資料並確立個案的健康問題為:體液容積過量/與腎臟調節功能障礙及水分攝取過多有關;知識增進的準備度/與高磷食物攝取過多有關;不遵從/與不規則服用藥物有關。筆者在此個案的照護過程中,發現個案透析中低血壓的問題與心臟血管狹窄的問題有關,透過氣球擴張術及支架置放術,及時改善個案體液容積過量所引起的問題;且運用衛教與家屬的配合,協助個案在外食中避免高磷飲食。藉由行為的修正,改善個案對於藥物的不遵從行為,協助個案維持更佳的透析生活品質。希望藉此照護經驗之分享,提供護理人員在照護血液透析病人之參考。
This article is to explore the nursing experience of a hemodialysis patient due to excessive volume of body fluid, resulting in physical and psychological impact. From 2017/11/20 to 2018/2/4, the author used Gordon's eleven health function assessments to collect data and establish the health problems of the cases: fluid volume excess/ kidney regulation function obstacles and the water intake too much; readiness for enhanced knowledge /excessive intake of high-phosphorus foods; non-compliance / irregular medications. During the care of this case, the author found that the problem of hypotension in the dialysis case is related to the problem of vascular stenosis. Through balloon dilatation and stent placement, the problem caused by excessive volume of body fluid is improved in time; Cooperate with family members to help patients avoid high-phosphorus diets in food. Through behavioral corrections, improve the non-compliance of drugs in cases and help them maintain a better quality of dialysis. It is hoped that the sharing of care experience will provide a reference for nursing staff to care for hemodialysis patients.