英文摘要 |
Purposes This paper discusses the nursing experience of a patient admitted to the intensive care unit after undergoing esophageal reconstruction surgery (gastric tube reconstruction and jejunostomy) for treating esophageal cancer. From April 24 to April 27, 2019, the author collected data using Gordon’s eleven functional health patterns through direct care and observation, physical assessments, communication, and reviews of medical records. It was confirmed that the main health problems the patient faces were acute pain, imbalanced nutrition (less than the body requirements), a lack of knowledge, and anxiety concerning postoperative jejunostomy feeding and wound care. During the nursing process, the author closely observed the postoperative wound pain reaction of the patient, provided analgesic drugs accordingly, and taught the patient non-drug pain control methods - such as distraction, deep breathing, and muscle massages. For problems of imbalanced nutrition (less than the body requirements), total parenteral nutritional support was provided via a central venous catheter, with enteral nutrition provided by jejunostomy feeding. The digestive situation of jejunostomy feeding was evaluated every day to adjust the calories provided via jejunostomy feeding; practical operation and teach-back exercises were applied to teach postoperative jejunostomy feeding skills and impart wound care knowledge. For the patient’s anxiety (resulting from uncertainty of the disease’s prognosis and concerns about subsequent treatment), the author listened to, expressed care for, encouraged, and accompanied the patient, and guided him to express his emotions so that his anxiety could be relieved, and he could rebuild his confidence in his treatment. It is hoped that the nursing experience shared here can provide a reference for nurses in caring for such cases in clinical practice to improve the quality of clinical care. (Cheng Ching Medical Journal 2022; 18(2): 74-83) |