運用圖像記憶法照顧一位血液透析高血鉀症患者之護理經驗

Nursing Care Experience of a Hemodialysis Patient with Hyperkalemia Using the Image Memory Method

本文是探討一位45歲女性病患接受血液透析治療所引發的身心壓力與衝擊。護理期間自民國99年2月13日至3月25日，藉由觀察、會談等方式蒐集資料，運用羅氏適應模式評估，確認問題有：知識缺失、潛在危險性感染、潛在危險性親職功能障礙三項護理問題。筆者運用圖像記憶法針對血液透析後的高血鉀症製作一本「高血鉀自我照護手冊」，內容包括：1.高血鉀症原因、症狀等、2.預防高血鉀的日常生活注意事項、3.一日水果可食份數圖、4.圖像記憶高血鉀食物，並予逐一說明，不但加強個案對高血鉀症的照護技巧，也適應高血鉀飲食限制的改變；鑑於接受血液透析治療的病患日漸增多，希望藉此個案報告與護理同仁分享照護經驗。

This case report looks at the physical and psychological impact on a 45 year-old female patient when she underwent hemodialysis. During the nursing period from February 13 to March 25, 2010, data was collected by observation and interview. The data was evaluated using the Roy's Adaptation Model and identified four nursing problems, namely knowledge deficit, potential danger of infection, health seeking behavior and the potential danger of parenting dysfunction. The author compiled a ”Self-care Handbook for Hyperkalemia” containing the four following subjects: (1) Hyperkalemia causes and symptoms; (2) Everyday Hints to Prevent Hyperkalemia through Image Interpretation; (3) Chart of permissible daily fruit portions; and (4) Image Memory of Hyperkalemic Food. The self-care handbook was explained item by item to the patient. Not did the handbook help to improve the patient's caring skills for hyperkalemia but also helped the patient adapt to the dietary changes caused by hyperkalemia. With an increasing number of patients now undergoing hemodialysis, this report is intended to share my experience with other nursing colleagues.