照顧一位入住加護病房初次血液透析患者之護理經驗

The Nursing Experience of Patient Who Received Initial Hemodialysis in ICU

本文為分享照顧一位末期腎臟疾病患者入住加護病房初次接受血液透析治療之護理經驗。護理期間自2010年7月4日至2010年7月6日，筆者於照護過程中經由直接照顧、身體評估、觀察、會談及運用Gordon十一項功能性健康型態評估等技巧收集資料，並加以分析整理，確立個案有：體液容積過量、知識缺失及調適障礙等健康問題。筆者除了教導個案學習水份控制及導管的自我照護外，更建立良好護病關係，了解個案真正的想法與需求，運用親人支持系統和提供正確血液透析知識，緩解個案焦慮，最終接受血液透析治療。期望藉由此次的護理經驗，提供加護病房護理人員日後臨床的照護參考。

The purpose of this article is to describe the nursing experience of a patient with end-stage renal disease (ESRD) that received initial hemodialysis in the intensive care unit (ICU).The author collected data and identified nursing problems through physical assessment, observation, interview, and Gordon's 11 functional health patterns. Body fluid overload, lack of knowledge, and disorder adaptation were identified as the nursing problems from July 4 to 6 in 2010. Apart from teaching the patient about fluid control and catheter self care, the author established a good relationship to learn about his thought and needs. Through the family support system and providing knowledge about hemodialysis, the patient's anxiety about undergoing hemodialysis was relieved. The experience will hopefully provide a useful clinical care reference for nurses on ICU.