一位接受全人工髖關節置換術之退化性關節炎患者的護理經驗

An Experience Providing Nursing Care to an Osteoarthritis Patient with Total Hip Replacement

本文為照顧一位 67 歲男性個案因患有退化性關節炎需接受全人工髖關節置換術之護理經驗。護理期間 2017 年 1 月 2 日至 1 月 10 日,運用觀察、會談、身體評估 與病歷查閱,以 Gordon 十一項功能性健康模式做整體性評估,發現護理問題有焦慮、急性疼痛、身體活動功能障礙、知識缺失、營養多於身體需要五項健康問題。 照護期間運用同理心與個案家屬建立信任關係,共同渡過手術前的焦慮;術後教導緩解疼痛與傷口照護的方法,以增進舒適、避免傷口感染;協助個案維持舒適臥 位;以示教方式進行復健運動計畫,逐漸恢復日常生活的活動功能,並在手術傷口恢復階段進行飲食的調整與教導體重控制。經由以上措施共同陪伴,使個案勇於面 對疾病手術所帶來的衝擊,並激發起自我學習照顧的動機,積極參與復健治療,恢復日常生活活動功能。藉此次護理經驗,對日後護理同仁在臨床能力上有所助益。

 

This report discusses a patient who received a total hip replacement due to the degenerative osteoarthritis. Nursing care was provided between January 2 and January 10, 2017. The overall nursing assessment (including observation, conver-sation, physical assessment, and medical record review) confirmed that the five key issues encountered by the patient were anxiety, acute pain, impaired physical mobility, deficient self-care knowledge, and imbalance of nutrition: more than body requirements. Empathy was applied during the nursing process in order to stabilize the trust relationship with patient and his families, and overcome surgery-related anxiety; effective pain treatment and wound care were performed after surgery to improve body comfort and avoid wound infection; an accurate body positions were facilitated to improve mobility; rehabilitation exercises were utilized to restore activities of daily living; an adjusted diet plan was applied to enable weight control. It hopes that the nursing experience shared can serve as a reference to nursing personnel for care of total hip replacement.