照護一位敗血症合併急性腎衰竭病童及其母親之加護經驗

A Nursing Experience of a Pediatric Patient with Acute Kidney Injury caused by Sepsis and her mother in the PICU

本文為照顧一位因敗血症合併急性腎損傷於加護病房內接受連續性腎臟替代性療 法之孩童及其母親的護理經驗。護理期間自2017 年9 月25 日至10 月6 日，藉由 直接照護、觀察、身體評估、病歷查閱、與家屬溝通等方式收集資料，確立個案主 要健康問題有：體液容積過量／與急性腎損傷有關，潛在危險性損傷／與敗血症引起 之凝血功能異常有關，害怕／與住院、與家人分開、接受治療有關，照顧者角色緊張 ／與病童病情、治療、環境有關等健康問題。於護理期間，筆者與個案及家屬建立信 任感，提供個別性的護理措施，改善個案的感染、呼吸、氧合的情形，監測血液動力 學，促進體液與電解質的平衡，維持個案的身體功能，滿足其身心需求，並增進家屬 對個案病情與照顧方式的瞭解，以減輕其焦慮。期望此護理經驗，能提供日後照顧此 類個案之參考。

 

This article describes caring for a child with sepsis and acute kidney injury, who received continuous renal replacement therapy in the intensive care unit and her mother. The nursing period was from September 25 to October 6, 2017. The data were collected through direct care, physical assessment and family communication. The main nursing problems in this case study include: excessive body fluids related to acute kidney injury; risks of injury related to abnormal coagulation caused by sepsis; fear of hospitalization, separation from family, treatment; caregiver’s stress related to child’s illness, treatment, environment, and other caring issues. During the caring period, the nurse established a sense of trust with the patient and her family, provided individual care measures, improved her infection, breathing and oxygenation, monitored the hemodynamics, promoted the balance between body fluids and electrolytes, maintained his physical function, and met the needs of her body and mind, in addition to alleviating her family members’ anxiety by helping them understand of the patient’s condition and treatment.