一位末期腎病變患者初次接受血液透析之護理經驗

Nursing Experience Caring an End Stage Renal Disease Patient Receiving His First Hemodialysis

本文為照護一位罹患末期腎病變患者首次接受血液透析之護理經驗。護理期間自2012年4月10日至5月10日，透過訪談及實地觀察收集資料，運用羅氏適應護理模式進行評估與分析，結果發現個案有：「體液容積過量」、「潛在危險性感染」、「調適障礙」、「焦慮」等健康問題，筆者針對個案擬定個別性護理計畫，教導個案控制適當水份攝取量，減少合併症發生，達到重建體液平衡之管理，透過主動關懷、同理心及信任感與個案建立良好的護病關係，提供血液透析等相關知識訊息，增加個案對疾病了解，並利用病友團體分享，以減輕個案焦慮感。另外，也期盼此個案的護理經驗協助臨床護理人員對照護類似患者能有更深的認識與瞭解，進而提供適宜的護理照護。

This case report describes the experience of nursing care for a 62 year-old, male end stage renal disease patient receiving his first hemodialysis. From April 10 to May 10, 2012, the author collected information using interviews, observations and direct nursing. Roy’s adaptation model was used to analyze the information. This revealed the patient’s nursing problems to be “excess fluid volume”, “risk of infection”, “adaptation disorder” and “anxiety”. Through individual nursing intervention, the author helped the patient comply with fluid restrictions, fluid management and measures to prevent related complications. The author established a trusting relationship with the patient through caring and empathy. The patient's anxiety about undergoing hemodialysis was relieved through support from a dialysis patients’ group and knowledge about hemodialysis. We hope that this holistic nursing experience can serve as a reference for nursing staff when caring for such patients.