照顧一位行肩關節鏡手術後病人噁心嘔吐之護理經驗

本文旨在描述一位行關節鏡手術後病人噁心嘔吐、疼痛及焦慮之護理經驗。護理期間為108年3月27-28日，筆者以Gordon十一項健康功能型態評估，透過直接照護、會談、觀察、身體評估、查閱病歷收集個案資料，發現個案擔心手術過程及術後恢復情形而有焦慮問題，手術後急性疼痛影響活動，且手術麻醉造成噁心嘔吐的不適感，故確立個案主要健康問題包括：急性疼痛、噁心嘔吐、焦慮。藉由與個案建立良好護病關係，傾聽及主動關懷個案，鼓勵表達內心感受，並提供適切護理措施協助降低個案手術後疼痛、噁心嘔吐，教導出院後的居家照護及後續復健，使個案早日恢復原有生活品質。未來建議門診可提供相關影音及圖片衛教，以利病人及家屬瞭解相關訊息，並提供住家鄰近之復健照護中心，協助病人持續復健，達到連續性照護。

關鍵字

肩關節手術；急性疼痛；手術後噁心嘔吐；焦慮

並列摘要

This article described a nursing experience of caring a patient with nausea, vomiting, pain and anxiety after shoulder arthroscopic surgery. During the nursing period from March 27 to 28, 2019, Gordon's eleven health functional patterns were used to collect data through direct care, interview, observation, physical assessment, and chart review. The authors found that the case had anxiety due to worry about the surgical process and postoperative recovery. She suffered from acute pain caused by surgery as well as nausea and vomiting caused by anesthesia. The identified health problems included acute pain, nausea and vomiting, and anxiety. We provided the case suitable nursing intervention to relief pain, nausea and vomiting by establishing a good relationship with the case, listening, actively caring, and encouraging to express her feeling. We taught the case home care and continued rehabilitation after discharge in order to restore the quality of life as soon as possible. It is recommended to provide relevant video and picture to help patients and their families understand the information about surgery in outpatient clinics. In addition, we can achieve continuous care through applying rehabilitation care center near their home to help patient continue to rehabilitation.

並列關鍵字

shoulder surgery ； acute pain ； postoperative nausea and vomiting ； anxiety

參考文獻

曲幗敏、許秀珠、林麗華、顧振玲（2018）．肩旋轉肌袖斷裂術後復健護理．源遠護理，12（1），17-25。https://doi.org/10.6530/YYN/2018.5.3.

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