運用Orem理論照護一位新發糖尿病患者併有酮酸血症之護理經驗

Nursing Experience of Caring for a New Diabetes Patients with Diabetic Ketoacidosis by the Application of Orem's Theory

本文是運用Orem理論照護一位新發糖尿病患者併有酮酸血症之護理經驗。在護理個案期間，筆者運用Orem自我照顧護理理論為臨床護理評估架構，並以觀察及會談的方式收集資料、進行完整性評估，發現個案有「呼吸道清除功能失效」、「體液容積不足」、「自我照顧能力缺失」、「焦慮」及「健康維護能力改變」等五項主要護理問題。針對護理問題給予護理活動，協助個案由完全代償性護理，進步到部份代償性護理；矯正對疾病的錯誤認知，使其認識自己的疾病，並且提供糖尿病及日常生活的相關衛教活動，以達到支持教育性護理，使個案病情獲得控制，順利返家自我照顧。

This article examines an application of ”Orem nursing theory” for looking after the new diabetes patients who also has complications of Diabetic Ketoacidosis (DKA). During the treatment, the author applied ”Orem nursing theory” as the clinical nursing instruction method and collected data from comprehensive assessments by observing and interviewing the patients. Five major nursing problems were revealed: ineffective airway clearance, fluid volume deficit, self-care deficit, anxiety, and health maintenance is altered. In order to control the development of diabetes, the author had applied some treatments such as offering nursing to partial compensatory nursing, and correcting the wrong recognitions from suffering. To further achieve the goal of the patient's self-support/self-education at home, the author also provided diabetes and some routine healthy and educational relative activities to the patients.