一位初患第一型糖尿病併酮酸中毒病童之護理經驗

The Nursing Experience of a Child with Type I Diabetes Mellitus Complicated with Ketoacidosis

本文為照顧一位初次罹患第一型糖尿病10歲學齡期兒童引發酮酸中毒之護理經驗，病童及家屬因不清楚照顧而感到焦慮。於2012年12月12日至2012年12月28日護理期間，以系統性評估為工具，透過直接觀察、會談等進行整體性評估，發現病童有：體液電解質缺失、營養狀況改變、焦慮、照顧者角色緊張等四個護理問題。照護期間以主動關懷、傾聽協助紓解緊張情緒來建立信任關係；並以同理心與支持的態度鼓勵表達情緒；運用治療性遊戲讓病童了解第一型糖尿病引發酮酸中毒的疾病特徵、自我照顧技巧；與病童及家屬共同討論找出適合解決問題的方法，使其順利返家並適應新的生活狀態。

This paper described the nursing experience for a 10 year-old school-age child who, admitted for hyperglycemia, suffered from type 1 diabetes complicated with ketoacidosis. The patient and his family members, lacking the knowledge to care for the disease, experienced a high level of anxiety. From December 12 through 28, 2012, with the application of system evaluation, a comprehensive assessment was conducted through direct observation and interviews to examine the patient’s health condition. The following health problems were identified: lack of body fluid-electrolyte, changing nutritional status, anxiety, and caregiver role strain. During hospitalization, a positive therapeutic relationship was established through active care, listening, and anxiety relief; and with empathy and support, the patient was encouraged to express emotions. Therapeutic games was used to provide the patient with disease characteristics and self-care techniques of type I diabetes complicated with ketoacidosis; and a joint discussion with the patient and family was held to discover solutions to the existing problems that would allow the patient to safely return home and adapt to the new lifestyle.