一位末期腎病患者於加護病房面臨血液透析衝擊之護理經驗

本文是探討一位末期腎病患者，面對初次接受血液透析後造成身心困擾的護理經驗。筆者於94年3月3日至94年3月8日護理期間運用Gordon十一項功能性健康型態評估工具，並藉由病史收集、身體評估、會談、觀察等方式，收集資料且進行資料之分析與整理，歸納個案呈現主要的護理問題為1.急性混亂，2.個人因應能力失調，3.潛在危險性感染，4.潛在危險性損傷等。在此期間筆者運用主動關懷、傾聽、同理心及醫療訊息提供等技巧，與個案及家屬建立良好的護病關係，以協助解決身心症狀之困擾，並在血液透析期間能有正向的態度，以調適疾病所造成的變化，終而能坦然面對血液透析治療。期盼此護理經驗的分享，能提供加護病房護理人員作為照護此類病患的參考。

關鍵字

末期腎病；血液透析；衝擊

並列摘要

The purpose of this report is to present the nursing experience of a patient with ESRD (end-stage renal disease )who had physical and psychological distress after first time of hemodialysis. During the period of care(3/3/94 to 3/8/94), the author assessed the patient’s condition used by the Gordon’s functional health assessment guide. Data was collected by history taking, physical examination, interview, and observation. The main problems of case report are: 1. acute confusion. 2. ineffective individual coping. 3. risk for infection. 4. risk for injury. In this period we established a nurse-patientherapeutic relationship with patient and family by caring, listening, empathy, and provide medical treatment information to help to solve symptom distresses and improve positive attitude toward in the hemodialysis period. The patient was also better able to adapt to his illness and to improve quality of life. Finally, patient was successful in hemodialysis therapy. The nursing experience from this case report can help nurses who will take care of similar cases in the intensive care unit.