協助一位糖尿病病人減少透析中合併症的護理經驗

The Nursing Experience of Helping a Diabetic Patient to Improve the Complications during Complications during Hemodialysi

糖尿病透析病患較非糖尿病透析病患有較高的透析相關合併症及死亡率。因此對糖尿病透析病人的醫護一直是透析醫護人員最大的挑戰。本文中筆者探討一位糖尿病透析病人透析中合併症的問題，運用護理過程及會談方式，以個案生理反應及心理層面的評估去收集資料，經由資料評估分析，個案在透析中的主要問題為兩次透析間體重增加過多、透析時廔管血流量不穩定、透析時的血液流失、潛在性感染等。經由給予的護理措施，提供解決方法，減少了個案透析中不適的身體症狀，讓個案獲得透析醫療療效，也提升個案及照顧者的生活品質。

Higher dialysis complication and mortality rate have been reported to occur frequently in diabetic hempdialysis patients than in non-diabetics. Therefore, it is always a challenge to both physicians and nurses to take care of the diabetic hemodialysis patient. The purpose of this case study was to investigate complications that occur during hemodialysis in a diabetic patient. Through the nursing process and interview, we collected data and evaluated the patient's physical and psychological reactions. We found some major problems including body weight overload before hemodialysis, unsteady fistula blood flow, blood loss during hemodialysis, and potential infection risk. By giving proper nursing care, patients' uncomfortable symptoms during hemodialysis can be improved, with a result of a better treatment outcome for the patient. Thus, this also can improve the quality of life both for diabetic patients and their caregivers.