血液透析合併低血糖病人之護理經驗

Nursing Care for a Hemodialysis Patient with Repeated Hypoglycermia

本篇探討糖尿病腎病變之個案接受透析治療8個月後，近3個月反覆出現低血糖急性併發症所引發之生、心理問題。護理期間：2009年4月6日至5月20日，筆者運用會談、傾聽及觀察等技巧以Gordon十一項功能性健康型態進行整體性評估，確立健康問題：健康尋求行為／落實自我血糖監測；特定知識缺失／血液透析與糖尿病飲食有關；潛在危險性損傷／低血糖急性併發症；無力感／對病情及治療變化無法掌握。個案因透析合併反覆性低血糖急性併發症，進而產生無力感，護理過程中運用同理心，建立治療性人際關係，針對其問題訂定適當目標，增強自我照顧技巧及信心，藉由新技能的學習逐漸增加自信心，展現積極正向行為，渡過無力感的危機。

This study describes nursing experience of caring for a diabetes and hemodialysis patient that experienced repeated Hypoglycermia. Patient care lasted from April 6th through to May 20th 2009. During this period, the author used listening, conversation and observation skills to assess the patient’s health problems using Gordon’s 11 functional health patterns and identified the following health problems: ”Ineffective health maintenance for monitoring blood sugar”, ”Deficient knowledge on preparing DM diet”, ”Risk of unstable blood glucose level” and ”Powerlessness”. After setting realistic goals, offering self care skills, and improving assertiveness, the patient demonstrated positive behavior and built up the confidence to endure through the crisis of powerlessness.