屍腎移植發生移植腎延遲腎功能病人之護理

Care of a Patient with Delayed Renal Function Who Received Cadeveric Renal Transplantation

本文乃應用羅氏適應理論，協助一位接受屍腎移植病患，適應移植腎延遲功能(delay renal function)衝擊之護理經驗。自90年6月12日至7月3日持續護理期間，評估其生理功能、自我概念、角色功能與相互依賴等四種適應導向，辨識個案所面對之刺激及其表現之適應行為，確立主要之健康問題有：體液容積過量、個人因應能力失調、高危險性成染與便秘。經由信任感的護病關係建立，以及善用個案支持系統，引導個案參與治療計畫，增加其控制成與希望；另一方面，與其他醫療團隊成員溝通合作，嚴密監測與處理其生理問題，維護移植腎功能，使個案順利渡過移植腎延遲功能的衝擊，適應移植後的生活改變。

The case report discusses the nursing process for a patient who received a cadaveric renal transplantion. The nursing process used to assist the patient to adjust the impact of the graft delay renal function based on Roy's Adaptation Theory. During continuous nursing care provided from June 12 to July 3, the author assessed her four factors of adaptation: ”physiological function”, ”self concept”, ”role function”, and ”interdependence”, to identify her stimulus and adaptive behavior. We also determined her primary health problems, wich were ”fluid volume excess,” ”ineffective individual coping.” ”infection, high risk for,” and ”constipation.” By establishing this patient's trust relationship in nurses and patients relationship and using client's support system, I induce her to join in the development of the treatment plan and thus enhanced her sense of control and hope. At the same time, I communicated and cooperated with the other members in medical team to closely monitor and manage her physical problem. Fortunately, the client overcame the impact of the graft delay renal function and successfully made adaptations in her life style change in response to the nursing assistance.