照顧一位肝性腹水患者併身體心像改變之護理經驗

A Nursing Experience for a Patient with Cirrhotic Ascites Complicated with Altered Body Image

梁倞玲(Ching-Ling Liang) ； 蘇郁雯(Yu-Wen Su) ； 林韋君(Wei-Chun Lin)

《馬偕護理雜誌》 7卷2期 (2013/07) Pp. 94-104

https://doi.org/10.29415/JMKN.201307_7(2).0009

摘要

本文描述一位37歲肝硬化患者，因反覆性腹水入院之護理經驗。筆者自2010年8月14日至2010年8月22日依Gordon十一項健康功能型態評估，藉由會談、觀察及身體評估等方式收集資料，確立個案主要健康問題有「體液容積過量」、「營養狀況改變－少於身體所需」、「活動無耐力」及「身體心像改變」，照護期間與營養師及家屬共同討論後，提供適切的飲食衛教及個別性護理指導，並提供漸進式活動計畫以改善活動無耐力，藉由正向鼓勵及陪同自我檢視外貌，使個案接受身體外觀因疾病進展的改變，並於出院後以電訪方式追蹤個案返家後的自我照顧能力。此護理經驗可提供臨床護理人員在照顧肝硬化合併腹水病患時，其生理及心理層面照護，能適時提供良好的護理指導及措施，增加病患自我照顧能力，同時減輕家屬照顧上的心理壓力。

關鍵字

肝硬化 ； 腹水 ； 身體心像改變

並列摘要

This article described the nursing experience for a patient with cirrhosis of liver and repeated hospitalization due to recurrent ascites. The period of nursing care was from August 14 to 22 of 2010. Data was collected by interview, observation and physical assessment with Gordon's functional health patterns. Identified major health problems were fluid overload, nutrition loss, activity intolerance, and altered body image. During the period of nursing care, we provided an appropriate individual nutrition support health education after discussion with dietitian and families. Individualized nursing interventions included progressive exercises program to improve the activity intolerance and encouraged self-view his appearance and faced that change in progress of illness. After discharge from hospital, track patient's self-care skills by telephone interview. This nursing experience serves as a reference for clinical nurses who care for cirrhosis of liver patients with ascites, about their physical and psychological care, and to provide good guidance with intervention for increase patient self-care ability, while reducing the psychological stress of families.

並列關鍵字

cirrhosis ； ascites ； body image change