運用自我調節理論於一位慢性腎臟病病人水份與血磷控制的護理經驗

Nursing Experience of Applying Self-Regulation Theory to Fluid and Phosphorus Control in a Patient with Chronic Kidney Disease

本篇是運用自我調節理論於一位慢性腎臟病病人水份與血磷控制之護理經驗，護理期間自98年10月26日至11月03日，個案因腎臟功能衰退導致全身性水腫、高血壓、虛弱、噁心嘔吐而入院治療，照護期間筆者以會談、觀察及病例查閱等方法收集資料，並進行整體性護理評估，確認個案有水分攝取過量與血磷控制不佳等健康問題。筆者以自我調節理論為架構擬訂護理措施，藉由教導個案自我監測表的應用，學習自我記錄每日水份攝取量與途徑、降磷藥物服用方式與飲食種類，自我判斷症狀控制不佳的原因，並藉由目標設定與自我反應達成正確的水份管理與血磷控制，幫助個案調整生活型態以與慢性腎臟病長期共存。

The study describes the nursing experience of applying self-regulation theory to fluid and phosphorus control in patient with chronic kidney disease (CKD) suffering from edema, hypertension, weakness, nausea and vomiting from October 26th to November 3rd, 2009. The author used interview, observation and medical records to collect data and to evaluate patient's health problems. The identified health problems include excessive fluid intake and poor phosphorus control. Using self-regulation theory as the basis for intervention, we taught the patient to use the self-monitoring records to track their own daily fluid intake, phosphate medication-taking behavior and diet. To achieve the preset goal of appropriate fluid management and phosphate control behavior, the patient was taught how to analyze the potential factors behind poor fluid control and phosphate level elevation. The intervention enhanced the patient's disease management and improved patient ability to adapt to the progression of CKD.