英文摘要 |
This paper describes the nursing experience on an 82-year-old hemodialysis patient who was hospitalized for fistula embolism several times. The author was in charge of the nursing care for the patient from December 11-20, 2002 and during that period; data was collected through direct nursing, observation, and talks with family members. It was analyzed with Gordon's Family Evaluation and Assessment. Three major nursing problems were identified: 1. fistula cannulation, embolism of blood access, and insufficient caring for blood access when in pain and during the dialysis treatment; 2. insufficient nutrition intake due to long-term hemodialysis, inflection of blood access, and less variety and food choice; 3. family dysfunction/inability to communicate and receive messages. Through the analysis of dialysis problems during hospitalization and nursing, we were able to meet the basic physical and psychological demands of the subject as well as establish medical contacts with the care giver at home in order to improve the awareness and caring skills of family members. The family was also given an end-stage renal disease handbook, and taught how to clean and maintain dialysis catheters and fistula photos to demonstrate points for daily caring. During hospitalization, the subject experienced pain because of the smooth circulation of the blood processing system. In addition, after understanding the skills to prepare food for the patient with renal disease, family members prepared food in greater varieties to satisfy the patient's appetite. Family members have acquired consistent nursing concept after establishing a communication model for medical problems. It allowed them to conduct daily monitoring in accordance with the nursing evaluation and assessment table designed by nurses and help the subject to be discharged from the hospital as scheduled. |