一位腎臟移植病患之手術全期護理經驗

Perioperative Nursing Experience of a Patient with Secondary Kidney Transplantation

本篇個案報告是敘述照顧一位腎臟移植病患之手術全期護理經驗。照護期間為93年9月17日至93年10月1日，以Gordon 11項健康功能性評估為基礎，運用手術全期護理模式，以觀察、傾聽、會談及查閱病歷等方式，對個案進行身體、心理、社會等方面的整體性評估。個案護理問題為：手術前期-焦慮/與即將面臨的手術及未知的結果有關；手術中期-潛在危險性損傷/與全身麻醉、手術設備、技術有關；手術後期-口乾、喉嚨痛/與手術中用藥、插管有關；急性疼痛/與組織損傷（手術）有關。在整個照護過程中，筆者以同理心、真誠的態度，與個案及家屬建立良好的治療性人際關係，於術前期提供相關手術訊息、心理支持；術中期－無菌技術操作的實施及監督、潛在危險性損傷的預防；術後期－應用專業知識治療及方法，減輕疼痛、重建個案之生理平衡、預防合併症的發生及給予個案自我照顧的衛教。個案及家屬在鼓勵及支持下參與整個治療過程，並渡過了手術期。希望此次的護理經驗，能與護理同仁分享。

The purpose of this case report was to describe the perioperative nursing experience in caring a patient who was undergoing kidney transplantation. The nursing process was from 2004/9/17-2004/10/1. The author applied Gordon 11-items functional health patterns as a theoretical frame work to assess the patient’s health problems include physical, mental, and social. The patient’s health problems revealed that : 1) at preoperative phase - Anxiety; 2) at intraoperative phase – Risk for Injury; 3) at postoperative phase –Acute Pain. Through the preoperative period, the author provided comprehensive perioperative nursing skills such as strong supportive, encouragement, company, closed observation, and monitoring patient’s safety and comfort in order to assist the patient and his family to face the challenges of surgery effectively. The result revealed that the patient could decrease anxiety before surgery and gain more confident by providing perioperative nursing.