照顧一位因中草藥行血液透析患者之護理經驗

Nursing Experience with a Hemodialysis Patient Who Had Used Herbal Medicine

本文主要在陳述一位因服用中草藥引發慢性腎臟疾病（chronic kidney diseases, CKD），而導致需長期行血液透析患者之護理經驗。護理期間自2007年10月17日至2007年10月28日，筆者利用羅氏適應模式進行護理評估，分析歸納個案主要問題為「因體液容積過多而致呼吸喘」、「疲憊」、「身體心像紊亂」、「角色扮演改變－角色轉換」。護理過程中筆者運用同理心與個案及家屬一起擬訂護理計畫及目標；藉由護理措施的介入、衛教執行及腎友支持，改善了個案呼吸喘、疲憊及因身體外觀改變而致的心像紊亂等問題，終使個案能積極的面對血液透析治療，並提升個人自我照顧能力和接受外觀的改變。期望藉此護理經驗，提供給血液透析護理人員參考，讓類似之個案能得到最適切的支持與照顧。

This article focus on nursing experience from October 17th to October 28th 2007 with a patient on regular hemodialysis due to herbal medicine induced chronic kidney disease. Using Roy's adaptation model, we analyzed the patient's situation and concluded that there were four major problems. These were (1) body fluid overload, (2) fatigue, (3) body image changes and (4) role transformation. We discussed these problems with the patient and her family using empathy and developed nursing programs and targets. Using these nursing programs, education, and support from other hemodialytic patients in the same unit, this patient's dyspnea was improved, her fatigue due to hemodialysis was reduced, and she began to better adapt to her body image alteration. We provided information about hemodialysis in order to help this patient understanding end-stage renal disease (ESRD); this allowed her to face hemodialysis therapy positively and actively. These changes, in turn, increased her selfcare ability, and her acceptance of the alterations to her body image. Finally, we hope that the application of similar appropriate nursing care and support will be available in other such ESRD patients through sharing our nursing experience with other hemodialytic nursing care systems.