照顧一位血液透析婦女在懷孕後期的護理經驗

Nursing Experience with Caring for a Female Hemodialysis Patient in Late Pregnancy

本文是探討一位接受長期血液透析婦女在懷孕後期的護理經驗，筆者於2008年8月6至10月2日期間，藉由直接照顧、會談、觀察、傾聽及電訪等方式收集資料，並採Gordon所提出的十一項功能性健康型態進行護理評估。發現個案有營養狀況改變：少於身體需要、焦慮及知識缺失等健康問題。在照護過程中，配合透析治療處置，並會診營養師提供適當的營養需求，來確保懷孕後期的胎兒成長；藉由提供正確資訊，並清楚說明會定時使用胎兒監視器，密切評估胎兒於腹中的狀況，來減輕其焦慮的情緒；並運用護理指導手冊及示範教學早產兒的居家照護技能和知識，增加個案對早產兒的照護知識及解決問題的能力。期待此特別的護理經驗能提供血液透析的護理人員照顧之參考。

This article explores the nursing experience of caring for a woman in late pregnancy receiving long-term hemodialysis between August 6 and October 2, 2008. The author collected data through direct care, interviews, observation, listening and phone conversations. Gordon's 11 Functional Health Patterns were used to carry out the nursing assessment. The author confirmed the diagnosis and found that the patient had some health problems including imbalanced nutrition (less than body requirements), anxiety and deficient knowledge. During the nursing process, dialysis treatment was coordinated with nutritionist consultations to ensure adequate nutrition for the development of the late pregnancy fetus. Through active care of the patient, provision of correct information, and clearly explaining how the condition of the fetus will be regularly monitored in-utero, the patient's anxiety was alleviated. Nursing handbook and education on skills and knowledge were provided to increase the patient's knowledge and ability to care for a premature baby at home. The author hopes that this unusual nursing experience will provide nursing staff with a useful reference during hemodialysis treatment.