照護一位Liddle Syndrome患者之護理經驗

Nursing Care for a Liddle Syndrome Patient

低血鉀是門診及住院病人中常見的電解質異常，當血鉀值低於3.5 mEq/L就可能降低細胞的興奮性，而使患者出現神經肌肉症狀，進而造成全身各系統功能的改變，如呼吸抑制、姿位性低血壓、肌肉無力及腸蠕動變慢等。本篇個案報告即是描述一位Liddle syndrome患者因低血鉀症，在住院期間面對疾病之生理及心理衝擊的護理經驗。筆者於個案住院期間，利用Gordon十一項健康功能型態評估，並以觀察、傾聽、會談及身體檢查評估技巧所得之資料，歸納出個案有營養不均衡、高危險性跌倒及便秘等健康問題。藉由以個案為中心的整體護理、運用關鍵性思考，而得以有效解決個案低血鉀之問題；此外，經由與個案建立良好護病關係後，深入瞭解其內心的想法及所關注的問題，提供心理支持，使個案的不適程度減輕，進而增進自我照顧之能力，並且能正向積極的面對疾病，獲致疾病的改善。期能藉由此一個案護理經驗之分享，作為臨床護理人員在照顧此類病患之參考。

Hypokalemia is a rather common electrolyte imbalance among hospitalized patients as well as outpatients. Those with serum potassium level less than 3.5 mEq/L are prone to reduced cell excitement and an increase in neuromuscular symptoms, such as respiratory suppression, postural hypotension, muscle weakness and intestinal issues wriggles slows down. This article will present the nursing experience of caring for a Liddle syndrome patient who suffers from hypokalemia-related physical and mental challenges. The authors assessed the patient's condition by means of the Gordon functional health pattern guide and clinical assessments. The client was concluded to have nursing problems such as inadequate nutrition, risk for falls, and constipation. The authors used client-centered nursing and critical thinking to improve the patient's hypokalemic state. After establishing a fine nurse-patient relationship and understanding the patient's mental health, the authors provided mental support to alleviate his discomfort and promote his ability to care for himself. The authors would like to share their experiences and hope that the report will be helpful to those who take care of similar patients.