護理一位攝護腺肥大病患的經驗

良性攝護腺肥大症是男性上了年紀後最常見的疾病之一，本篇報告係照顧一位BPH患者，接受TURP術後產生的一連串問題及相關護理措施的呈現。筆者是個案主護護士，運用生理、心理、社會、發展、靈性等方面評估其護理問題。歸納個案術後呈現主要護理問題為：1.高危險性感染/導尿管留置，2.排尿型態改變:尿失禁/TURP術後所引起的損傷，3.身體心像紊亂：身體功能改變/無法自行控制排尿功能，4.知識缺失：特定的/對TURP術後注意事項不了解。而針對上述問題所給予之護理措施主要為：1.教導留置導尿管的護理，2.提供改善尿失禁的護理，3.提供身體心像紊亂的護理，4.教導術後日常生活須知。以協助患者順利的渡過整個手術過程及術後相關的問題。筆者在照顧此患者的護理過程中，深覺護理人員若能對病患做完整的評估，將有助於確立問題，及提供適切的護理措施。因此建議護理人員應加強整體性的護理評估，針對個案的護理問題，提供連貫且一致的個別性護理及出院後追蹤。

關鍵字

良性攝護腺肥大；經尿道攝護腺切除術；護理

並列摘要

The purpose of this report is to illustrate an experience on caring one patient with diagnosis of BPH post TURP. The author was his registered nurse. She assessed his problems through physical, psychological, social, developmental, and spiritual divisions. The main problems of this case in the report are 1. Infection, risk for placement of urinary catheter. 2. Urinary elimination altered related to trauma post surgery of TURP. 3. Body image disturbance related to unable to control elimination by him. 4. Knowledge deficit specifies to caring post TURP. Based on the problems stated above, the interventions given were 1. Teach how to care of urinary catheter. 2. Provide ways to modify urinary incontinence. 3. Provide nursing interventions concerning his conflict on body image. 4. Instructing the patient how to deal with his daily life post operation to support him go through well. During this care experience, the author feels deeply that if nurses can do thoroughly assessment in advance would greatly help in set up problems and suggesting more suitable nursing care and follow after discharge. Hence, the author also suggested that nursing staffs should strengthen their assessing technique by a comprehensive way. Furthermore, extend care to home setting with continuous and individual aspects.