照顧一位人工膝關節置換術後併發周邊血管阻塞病患的護理經驗

Nursing Experience of a Patient with Complication of Peripheral Vessel Occlusion after Total Knee Replacement

本文主要探討一位因右膝關節退化接受人工膝關節置換手術，術後併發右膝膕動脈阻塞的個案，在面對非預期性併發症的心理衝擊過程。筆者於護理期間擔任個案主護護士，經由觀察、會談及身體評估等方式收集資料，運用羅氏適應模式進行整體性評估，確立個案有周邊血管組織灌流失效、睡眠型態紊亂、焦慮等護理問題。護理過程中協助個案緩解肢體麻木、冰冷所帶來的不適，並適時給予鼓勵及指導，進而改善個案因疾病引發的焦慮及失眠問題。期望藉此護理經驗之分享，能提供護理人員於臨床照顧時，除重視個案生、心理需求外，更需提供正確完整的身體評估，進而協助醫療團隊及早發現個案術後潛在的問題及異常徵象，以降低個案的傷害。

This case study reported the nursing experience of a patient with complication of occlusion of popliteal artery after total knee replacement on the right leg. Three major nursing problems - altered peripheral vessel tissue perfusion, sleep pattern disturbance, and anxiety were found by using Roy’s adaptation through observation, interview, and physical assessment. Nursing intervention programs included listening, providing caring, and empathy to improve patient’s discomfort and to maintain body function. The purpose of this report was to share nursing experience to assist medical group to find out client’s potential problems at early stage.