一位消化潰瘍出血的老年病人之護理經驗

A Nursing Experience of an Elderly Patient with Peptic Ulcer Bleeding

本文敘述一個因消化性潰瘍導致胃出血的老年病人自加護病房急性觀察治療轉出後的持續病房照護經驗，護理期間自2005年3月22日至2005年3月30日，筆者藉由Gordan十一項健康功能評估為架構，並以觀察、會談及運用身體評估等技巧收集資料及確立問題，發現個案有體液容積缺失、潛在危險性跌倒及無效性健康維護能力等問題。 於護理過程中，以老年人護理的原則，給予有計劃之護理措施，密切評估出血狀況，及早發現出血的變化，即時的報告與處置，避免了體液容積缺失可能引發的休克等嚴重合併症，並運用適合老年人的衛教，預防住院期間跌倒事件之發生、協助個案及家屬建立正確的健康觀念，增進健康維護能力，以預防疾病復發。This paper reports an experience of nursing an elderly patient who suffered from peptic ulcer bleeding. Based on the model of Gordan's Functional Health Patterns, the authors gathered client information with the use of observation, interview and physical assessment skills, from Mar. 22 to 30, 2005. Three health problems were identified from the information, including fluid volume deficit, potential high risk of falling, and ineffective health maintenance. The nursing care process was based on the principles of gerontology nursing and the planned care was provided to prevent complications such as shock, which may result from bleeding-induced fluid volume deficit. The health education was made to meet the particular elderly patients' needs, which focused on preventing the occurrence of falling during the hospitalization and assisting the subject and the family in gaining the ability to maintain health and prevent the reoccurrence of peptic ulcer.