一位酒精性肝炎患者急性癲癇發作之急診護理經驗

A Nursing Experience of Caring for an Epileptic Patient Secondary to Alcoholic Hepatitis

本文旨在探討一位酒精性肝炎患者急性癲癇發作之急診護理經驗。護理期間為2010年4月12日至4月16日，藉由溝通、會談、身體評估及查閱病歷方式收集資料，運用Gordon十一項功能健康型態進行評估，確立個案之主要護理問題，包括腹瀉、潛在危險性跌倒、不遵從及長期性低自尊。於護理過程中運用同理心、關懷、接納、尊重及傾聽技巧，與個案建立良好的護病關係，扮演教育與指導的角色，協助個案配合醫師的治療與控制，改善腹瀉情形及預防癲癇再發作。經由專業諮詢、社會支持系統及醫療團隊合作方式，最終個案能瞭解戒酒及按時服用抗癲癇藥對疾病控制的重要性。後續經由電訪追蹤個案表示能定期回診服藥，且於精神科門診接受戒酒治療。希望藉此護理經驗能提供護理同仁照顧此類病人之參考。

This report describes a nursing experience of caring for a patient with alcoholic hepatitis. The patient was admitted for an acute epileptic episode. During the nursing period from April 12 to April 16, 2010, Gordon's 11 functional health assessment tool was used for data collection. Through interview, observation, physical examination, and medical chart review, the following major health problems were identified: diarrhea, high risk for fall, noncompliance of medication administration, and low self-esteem. The author established a therapeutic relationship with the patient by means of authentic listening with empathy, caring, and acceptance with respect. As n educator and guider, the author assisted the patient in receiving treatment for diarrhea and preventing future epileptic reoccurrence. With professional consultation, social support, and multidisciplinary collaboration, the patient understood the importance of quitting alcoholic drinking and taking antiepileptic medication regularly for disease control. A telephone follow-up indicated the patient's following return appointments as scheduled and compliance with taking medication. The patient also regularly visited the psychiatric clinic for cognitive behavioral therapy for quitting alcoholic drinking. This nursing experience is shared with nurses taking care of patients with a similar condition.