照護一位血液透析病人經歷動靜脈血管反覆阻塞之護理經驗

Care of a Hemodialysis Patient Faced with Repeated Obstruction of Arteriovenous Fistula Care Experience

本文是探討一位血液透析病人經歷動靜脈管反覆阻塞的護理經驗，筆者於2010年3月27日至5月31日照護期間，藉由直接照護、會談、電訪及身體評估等方式，運用Gordon十一項健康功能型態評估進行資料收集，確立個案呈現體液容積過量、健康維護能力改變、無望感等健康問題。護理過程中，筆者與個案、案妻共同擬訂飲食（水分）控制及動靜脈管的照護計畫，協助設計「每日水分攝取量與體重記錄表」及「管自我照護檢測本」，以增進個案自我健康照護能力；並安排個案及案妻參加腎友會、團體衛教等活動，提供支持系統和提升自我價值感，協助個案以正向的態度面對透析治療、降低無望感。期望藉由此個案的護理經驗分享，提供護理同仁照護相關個案之參考。

This article explores the nursing experience of caring for a hemodialysis patient with recurrent obstruction of arteriovenous fistula from March 27 to May 31, 2010. The author collected data through direct care, interview, phone conversations and physical assessment. Gordon's functional health patterns were applied to evaluate the patient. The patient's health problems included excess fluid volume, change in health maintenance ability and hopelessness. During the nursing process, the author worked with the patient and his wife to establish the therapeutic daily water intake, body weight record sheet and fistula self-care checklist. Personalized care plans were developed to enhance the patient's self-health management ability. We also arranged for the patient and his wife to attend support groups and health education programs to provide them with a support system, improve self-esteem, help the subject come to terms with dialysis treatment and reduce the sense of hopelessness. By sharing the nursing experience from this case, we hope to provide other nurses with a useful reference when caring for similar cases.