照顧一位鉻酸中毒個案護理經驗

The Nursing Experience of Patient with Chromium Poisoning

本文個案為一電鍍工人跌入電鍍池吞入化學液，而引起鉻酸中毒，在2012/1/20-2012/1/25加護病房護理期間，筆者藉由身體評估、Gordon十一項健康功能型態、會談、觀察進行護理評估，確立有三項護理問題：一、現存性傷害／與鉻酸中毒後導致肝腎損傷有關；二、急性疼痛／與鉻酸強腐蝕性造成黏膜受損有關；三、焦慮／對治療及預後的不確定感有關。照護過程藉由文獻搜尋了解鉻酸中毒所造成的危害，運用護理專業知識密切監測生理變化，預防出現併發症，並運用疼痛評估、心理支持緩解個案因黏膜受損造成的急性疼痛，同時主動關懷個案對治療不熟悉及預後的不確定感所引起的焦慮，協助調適並找出因應方式。期望藉此護理經驗分享做為往後照護相關個案之參考。

The subject of this study was a galvanization worker who suffered from chromium poisoning after falling into the galvanization tank and ingesting the chemical solution. During the period of intensive nursing care from January 20 ~ 25, 2012, the author collected data on the patient through physical examinations, interviews, patient observation and Gordon's 11 functional health patterns. The patient was confirmed to have three nursing problems: 1. Existential injury - related to the risk of acute liver and kidney damage from chromium poisoning; 2. Acute pain - related to membrane damage caused by the corrosive effects of chromic acid; 3. Anxiety - related to uncertainty over treatment and the future. During the care process, the author studied the literature on harm caused by chromium poisoning then used the specialized nursing knowledge to closely monitor the patient’s physiological changes and prevent any complications. Pain assessment and psychological support were also used to help relieve acute pain that the patient was suffering from mucosal damage. We actively helped the patient find ways of coping with the anxiety from unfamiliarity with the treatment process and uncertainty over his future as well. We hope the sharing of this nursing experience can serve as a reference when caring for similar cases in the future.