照護一位末期腎臟病病患初次接受血液透析之護理經驗

The Nursing Experience of Caring for an End Stage Renal Disease Patient who Received Initial Hemodialysis

本文闡述一位腎功能異常的病患因服用不明的中草藥加速病程進展，使其面對初次血液透析之護理經驗，照護期間為2017 年4 月10 日至2017 年6 月23 日，筆者運用直接照護、觀察、會談、身體評估及檢驗數值等方式收集資料，依據Gordon 十一項健康功能型態評估歸納出體液容積過量、知識缺失、無望感等健康問題。照護過程筆者運用關懷、傾聽及同理心等技巧，接納病患負向情緒，鼓勵表達內心感受，陪伴其面對透析治療的衝擊。擬定個別性照護計畫，提供居家照護資訊，強化自我照顧技能，使病患能改善體液容積過量的問題，並教導減少高磷食物的攝取，提升正確規則服用降磷藥物的行動力，藉由家人的支持及腎友的經驗分享，協助病患以正向積極的態度面對新的生活模式。

 

This paper described the nursing experience for a renal disease patient who accelerated to end-stage from taking unknown Chinese medicine during the therapy. The period of nursing care was from April 10, 2017 to June 23, 2017. Data were collected through clinical care, observation, interviews, physical assessment and chart reviews. Based on Gordon’s 11 Functional Health Patterns, the following major nursing problems were identified: (1) excessive body fluid volume, (2) lack of knowledge and (3) hopelessness. During the caring process, the author used the techniques of caring, listening and empathy to incorporate the negative emotions of the patient, encouraged to express her inner feelings, and faced the impact of hemodialysis treatments with her. Individual care plans were developed to provide her with accurate home care information and strengthen her self-care skills to help the patient improve on the issue of excessive body fluid volume, taught her to reduce the intake of highphosphorus foods, and improved his ability to take phosphorus-lowering drugs with the correct rules. What’s more, through the support of her family and experiences shared by other kidney disease patients, they helped the patient use a positive and activate attitude to face a new way of living.