照護一位血液透析併紫色尿袋症候群個案之護理經驗

Nursing Experience of a Hemodialysis Patient with Purple Urine Bag Syndrome

本文個案因近期發生尿管及尿袋呈現紫色，長期便秘，主要照顧者自覺照顧不佳，且家裡無替代人手可協助照顧個案，導致壓力負荷過重，故引發筆者做深入評估與照護動機。護理期間自2015 年8 月3 日至2015 年11 月2 日，於個案進行血液透析期間以觀察、會談、及身體評估等方式收集資料，並以Gorden 十一項健康功能型態進行個案及主要照顧者之護理評估，歸納出個案的護理問題分別為現存性泌尿道感染、便秘及照顧者壓力負荷。照護期間運用主動關懷、傾聽技巧，以強化主要照顧者照護知識和照顧能力，使個案之紫色尿袋及便秘獲得改善，並提供社會及長期照護資源之訊息，邀請家庭成員共同協助照顧個案，鼓勵參加腎友團體，使得主要照顧者減輕壓力負荷。本次護理過程體認到洗腎室儼如腎友的第二個家，建議血液透析室護理人員在照顧透析個案時，應將個案本身及主要照顧者視為整體考量，適當運用社會資源，讓個案及其家庭成員在生理、心理、社會層面獲得完善的照護，不僅能提升個案的照護品質，也能提升家人的生活品質。

 

Purple urine bag syndrome (PUBS) is a condition in which the urinary catheter bag develops an intense purple coloration. It is mostly noted in chronically catheterized and constipated women. This article described a nursing experience of an elderly patient undergoing hemodialysis who suffered from PUBS, and the main caregiver overwhelmed by care strain. After applying the eleven functional health patterns as described by Marjory Gordon, it was noted that the nursing assessment clarified issues including latent risk infection, constipation, and ineffective family coping during the nursing period from August 3 to November 2, 2014. Individualized and continuous care were provided to assist the patient and family including: probiotics to improve constipation, nursing education for building up the main caregiver’s knowledge and skill of PUBS, more information about respite care for caregivers to stabilize the patient’s family function. This care experience recommended that the patient and the caregiver should consider social resources and complete care overall, in order to improve the care quality of patient and the families’ quality of life.