一位多囊性腎病患者接受血液透析治療的護理經驗

A Nursing Experience of a Patient With a Polycystic Kindney Receiving Hemodialysis

本篇描述一位多囊性腎病導致腎衰竭的病人，從抗拒血液透析到接受的護理經驗。目前對於多囊性腎病仍無法阻止其繼續惡化，最後都必需接受血液透析治療，如同此個案終究走上洗腎命運。筆者在照護過程中運用Gordon 11項健康功能評估，發現個案的主要問題有1.體液容積過量2.調適障礙3.知識缺失。筆者除了照顧個案身體不適之外，並運用同理心來幫助個案對於血液透析的認識，提供相關資訊與建立正向態度，終讓個案接受規律的透析治療，及能正確的執行日常生活保養。身為一位血液透析護理人員，最常見到的是病人對於洗腎的恐懼及抗拒，要讓病人坦然接受洗腎事實及保有良好的生活品質，須依個案的個別性，給予適當的護理措施。希望此護理經驗可提供相關臨床人員，在照護初期接受血液透析病人時可能會遇到的問題，並協助病人適應血液透析為生活的一部份。

This article described a nursing experience for a patient with kidney failure due to a polycystic kidney. The patient refused to receive hemodialysis as a treatment when initially suggested by the physician. Polycystic kidney disease remains incurable and hemodialysis is part of the treatment for the patient with kidney failure secondary to polycystic kidney. By using Gordon's 11 functional health assessment guidelines, the author identified the patient's main problems, including excessive body fluid, maladaptation, and knowledge insufficiency. During the period of nursing care, the patient's physical discomfort was relieved. The author provided adequate information about hemodialysis and helped the patient build up a positive attitude toward hemodialysis. The patient accepted regularly scheduled hemodialysis and a modified healthy life style. As hemodialysis nurses, we often see patients' fear and rejection when they have to confront the treatment of hemodialysis. In order to help patients accept hemodialysis as a treatment and maintain their quality of life, nurses need to provide the most suitable nursing measures to meet individual needs. By sharing personal experiences, the author hoped to provide this information about caring for the patient with kidney failure facing hemodialysis as a reference.