照顧一位胸腺瘤合併純紅血球再生不良患者接受手術之護理經驗

Experience of Nursing a Post-Operative Thymoma Patient with Pure Red Cell Aplasia

本文探討一位46歲胸腺瘤合併純紅血球再生不良患者，接受胸腺切除手術前後生理及心理衝擊的護理過程。筆者於個案住院期間以回溯紀錄、訪談、觀察及醫療團隊討論等所有資料，運用Gordon 11項功能性健康型態進行評估，歸納個案有呼吸道清除功能障礙、潛在性感染、疼痛、身體心像紊亂、焦慮等健康問題；經由直接照顧、給予手術前後護理指導、疼痛緩解，及運用會談等技巧，提供相關護理措施，疏導其勇於面對種種衝擊所產生的問題，提供妥善照顧得以順利出院。藉由此次經驗體悟護理人員應努力汲取新知，對病患背景作整體評估，及早確立問題並提供適切護理措施，發揮專業護理功能，以協助病患減輕痛苦、早日恢復健康。

This paper was to discuss the nursing process of caring a 46-year old female patient, diagnosed thymoma with pure red cell aplasia, and her psycho-physiological impact before and after operation. Gorden 11 health-physiological scale was utilized in this study to evaluate the patient. For data collection we used retrospective method, interview, observation, and the findings after discussing with health team members during hospitalization. The author solved the problems of the patient after evaluation, including disorder of respiratory stract, infection potential, body and mind disorders, and anxiety. Once the problems were identified, the patient was put under the direct care of the author. Pre and post operation instruction, pain relief and conversation with properly care and interventions were applied to the patient to help her encounter the impact of the problems. After the patient's smooth recovery and discharge, the author recognized that nurses should update their professional knowledge in order to have abilities to serve patients and take accurate evaluation of and identify patients' problems earlier so as to give competent nursing interventions and help them return back to normal life as soon as possible.