減重手術後併發腹內膿瘍病人之護理經驗

Nursing Experien ces in A Patien t with Intra-Abdomina l Abscess after Receiving Bariatric Surgery

本文為說明照護一位接受減重手術後，因吻合處滲漏併發腹內膿瘍而再度入院之個案，造成個案身體不適及心理承受很大壓力，而衍生相關情緒反應之護理經驗。護理期間自2014年4月24日至2014年5月4日，藉由Gordon十一項健康功能型態作為評估工具並利用觀察、會談、身體評估收集資料，經分析歸納後主要護理問題:現存性感染、急性疼痛及焦慮。護理期間教導放鬆技巧、緩慢深呼吸及影視娛樂轉移注意力，以緩解個案疼痛；在飲食方面，指導個案採階段性飲食並觀察個案進食後情形，藉傾訴陪伴正向友善及由醫療團隊向個案說明治療進展，減輕個案焦慮，使個案身心得到康復。經由照護此個案護理經驗，建議臨床護理人員，除著重在術後照顧外，應教導病人自我觀察術後相關併發症，提高其自我照顧能力及生活品質。

This article illustrates the nursing experiences of a patient’s re-admission due to intra-abdominal abscess at anastomosis leak following bariatric surgery. This problem gave her physical discomfort and severe emotional stress. The nursing interventions focused on helping her face negative emotional behaviors. The nursing period was from April 24 to May 4 in 2014. An assessment by Gordon’s 11 functional patterns and skills in observation, interview and physical assessment, and the patient’s data were collected. The main nursing problems analyzed and induced were existing infection, acute pain and anxiety. During the nursing period, interventions including relaxation techniques, slow deep breathing, and video entertainment alleviated her pain. As for diet, teaching her gradual intake of food and observing the reactions at each meal were conducted. Explaining the treatment plan to the client by team work could reduce her anxiety to finally restore her physical and mental health. Through the client’s nursing experiences, it is suggested nursing staff not only take care of patients post-operation but also teach patients to personally observe the complications after surgery for improving self-care abilities and life quality.