照護一位血液透析病人合併不寧腿症候群之護理經驗

Nursing Experience of a Hemodialysis Patient with Restless Leg Syndrome

本文旨在描述一位定期接受血液透析合併不寧腿症候群(RLS)之病人，面臨RLS之症狀及透析間體重增加超過乾體重5%以上，所造成的生理及心理衝擊的護理經驗。護理期間自2014年3月3日至5月7日。藉由個案每週一、三、五之血液透析治療時間，運用Gordon 十一項健康功能型態評估，確立個案有：「體液容積過量」、「睡眠剝削」及「無力感」之健康問題。於護理過程中，筆者藉由陪伴、傾聽並鼓勵個案說出心裏的感受，另外強化社會支持系統及協助個案正向思考，以增加對疾病的控制感及對護理指導的遵從度；教導腿部伸展運動及腿部穴位按摩，以降低RLS之症狀嚴重度及增加睡眠時數；教導在日常生活中控制鹽分及水分的原則，以達到透析間維持體重增加不超過乾體重5%。盼藉此經驗能提供護理人員作為日後照顧類似病患之參考。

This case report described the nursing experience of a hemodialysis patient with restless leg syndrome (RLS), who dealt with physical symptom and psychological impact. The nursing period was from March 3 to May 7, 2014, and the eleven Gordon’s functional health patterns assessment was applied to gather data when the patient accepted dialysis on Monday, Wednesday and Friday at the hospital. The patient was found to have several nursing problems, including body volume excess, sleep deprivation, and powerlessness. The authors provided accompany, listened to the patient, and encouraged him to express his feelings. Moreover, strengthened social support system was provided and the patients was encouraged to have positive thinking to increase self-control and improve compliance with nursing instruction. In addition, the patient was taught to perform leg stretching exercises and leg acupressure to decrease the disease severity increase sleep hours. Also, the author provided dietary guideline for daily sodium and water intake restriction to control interdialytic dry weight increase under 5%. We would like to share our experiences and provide information for caring similar patient.