糖尿病患者低血糖之急診護理照護

本文旨在描述一位糖尿病病人因低血糖昏迷由119送入急診之照護經驗。護理期間自2008年10月18日16時58分至22時30分，運用Gordon十一項功能性健康評估為架構，藉由身體評估、觀察、會談及直接照顧等方法收集資料，發現個案有急性混亂與血糖值過低有關；焦慮與疾病造成健康威脅及缺乏低血糖的知識有關。經由提供安全的環境、靜脈注射持續滴注，並鼓勵進食；積極探視並鼓勵個案說出對疾病的感受、鼓勵家人在旁陪伴；告知糖尿病的相關知識及低血糖的預防及處理方法，結果個案於急診觀察期間未出現意識不清且血糖值維持正常；表示因有先生陪伴在旁而感到安心，能說出低血糖的症狀、處理及預防方法。

關鍵字

低血糖；急性混亂；焦慮

並列摘要

The purpose of this report is to describe nursing experience while taking care of a 58-yearold female patient who had suffering the effects of hypoglycemia and had arrived at the emergency room after a call to 119. The nursing period was from 16:58 to 22:30, Oct 18, 2008. We used the 11 items of Gordon's Functional Health Pattern Model as an assessment framework together with related data obtained by physical assessment, observation, direct care and interviewing the patient. By this means we were able to establish that the acute confusion was related to low blood sugar. In addition, her anxiety was related to a lack of knowledge and because the disease causes a health threat. Therefore we offered a safe environment in which she was treated with four ampoules of 50% glucose by intravenous injection, given a 10% glucose parenteral solution via continuous instillation and encouraged to take food. Companionship, encouraging the patient to talk about the disease, allowing her to ask questions and encouraging the family to actively help were also used. She was presented with relevant knowledge on how to prevent hypoglycemia and the methods of treatment of diabetes. This case did not presented with loss of consciousness and normal blood glucose was finally established in the emergency department. This case feared a recurrence of hypoglycemia, but the presence of her husband helped to eliminate a feeling of letting the side down. She could now talk about the symptoms, treatment methods and preventive approaches to hypoglycemia.

並列關鍵字

hypoglycemia ； acute confusion ； anxiety

國際替代計量

糖尿病患者低血糖之急診護理照護

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