一位紅斑性狼瘡引發腎絲球腎炎病人之護理經驗

Nursing Care Experience of a Patient with Glomerulonephritis Caused by Systemic Lupus Erythematosus

本文探討一位58 歲女性因罹患紅斑性狼瘡引發腎絲球腎炎之護理經驗。護理期間為2017 年1 月20 日至2 月1 日，運用Gordon 十一項健康功能型態進行評估， 藉由直接照護、觀察、會談、收集病史及查閱病歷等方式收集資料，歸納出主要護理問題為：體液容積過量、潛在危險性感染及焦慮。照護期間，記錄每日輸入出量 及體重，以維持體液容積平衡；觀察管路傷口有無紅腫熱痛情形，降低感染發生；教導個案與家屬漸進式肌肉放鬆技巧及衛教疾病相關知識，以減輕焦慮及對疾病 不確定感。筆者藉由良好的護病關係，主動關懷及傾聽個案內心不安，經跨團隊合作，提供正確的疾病資訊及預後，協助個案以正向態度面對疾病及治療，利於後續 出院後自我照顧，進而提升照護品質。

 

This article explores a 58-year-old woman’s nursing care experience with renal glomerulonephritis caused by lupus erythematosus. The period of nursing care was from January 20 to February 1, in 2017. Using the Gordon’s 11 healthy functional modalities for evaluation, the author collected data by direct care, observation, interviews, collecting medical history and reviewing medical records, and thus identified three major nursing problems as follows: fluid volume overload, high risk of infection and anxiety. During care, daily input volume and output volume and body weight were recorded to maintain the body fluid volume balance; we observed the presence or absence of redness, swelling, fever, and pain in the catheter wound to reduce infection; and taught cases and family members progressive muscle relaxation techniques and promoted disease related knowledge to alleviate anxiety and uncertainty about the disease. Through a good nursing-patient relationship, the author took the initiative to care about and listen to the inner anxiety of the patient. Through cross-team cooperation, we provided correct disease information and prognosis, assisted patients to develop a positive attitude to face the disease and treatment and facilitated self-care after subsequent discharge, thereby improving the quality of care.