Pub Date : 2023-08-01DOI: 10.53106/172674042023082102001
楊馥妃 楊馥妃
本文描述一位罹患末期腎病病人初次接受腹膜透析治療因導管滲漏引發傷口皮膚不適及焦慮情緒之護理經驗。護理期間為2019年1月2日至2019年3月8日,筆者運用Gordon十一項健康功能評估為指引,透過直接照護、會談、觀察和查閱病歷等方式收集資料分析,確立個案有:營養狀況少於身體所需、潛在危險性感染及焦慮等健康問題。護理過程中,會診營養師並藉手機APP、衛教單張及影片來增進其對透析飲食的認知,以達到營養狀況改善;協助指導導管傷口的照護,遵守無菌原則換藥,避免皮膚受損預防感染發生;採取主動關懷,鼓勵說出內心感受,協同醫師說明再次手術過程增進信心,教導放鬆技巧及精油按摩,以減低焦慮感。希望此照顧經驗,能提供臨床照護類似個案之參考。 This article describes the nursing experience of a patient suffering from end-stage renal disease undergoing peritoneal dialysis for the first time because of catheter leakage caused by wound skin discomfort and anxiety. The nursing period is from January 2 to March 8,2019.The author used Gordon’s eleven health function assessments as a guide to collect data and analyze through direct care, interviews, observations, and medical records. The problems are as follows: Health problems such as nutritional status less than what the body needs, potentially dangerous infections and anxiety. During the nursing process, consult a nutritionist and use the mobile phone APP and Health Education Leaflet and video to enhance the cognition of dialysis diet, so as to improve the nutritional status; assist in guiding the care of catheter wounds, follow the principle of aseptic techniques, and avoid skin damage to prevent infection;Take active care, encourage patient present inner feelings, cooperate with the doctor to explain the procedure again to increase confidence, teach relaxation techniques and massage with essential oils to reduce anxiety. I hope that this care experience can provide a reference for clinical care of similar cases.
本文描述一位罹患末期肾病病人初次接受腹膜透析治疗因导管渗漏引发伤口皮肤不适及焦虑情绪之护理经验。护理期间为2019年1月2日至2019年3月8日,笔者运用Gordon十一项健康功能评估为指引,透过直接照护、会谈、观察和查阅病历等方式收集资料分析,确立个案有:营养状况少于身体所需、潜在危险性感染及焦虑等健康问题。护理过程中,会诊营养师并借手机APP、卫教单张及影片来增进其对透析饮食的认知,以达到营养状况改善;协助指导导管伤口的照护,遵守无菌原则换药,避免皮肤受损预防感染发生;采取主动关怀,鼓励说出内心感受,协同医师说明再次手术过程增进信心,教导放松技巧及精油按摩,以减低焦虑感。希望此照顾经验,能提供临床照护类似个案之参考。 This article describes the nursing experience of a patient suffering from end-stage renal disease undergoing peritoneal dialysis for the first time because of catheter leakage caused by wound skin discomfort and anxiety. The nursing period is from January 2 to March 8,2019.The author used Gordon’s eleven health function assessments as a guide to collect data and analyze through direct care, interviews, observations, and medical records. The problems are as follows: Health problems such as nutritional status less than what the body needs, potentially dangerous infections and anxiety. During the nursing process, consult a nutritionist and use the mobile phone APP and Health Education Leaflet and video to enhance the cognition of dialysis diet, so as to improve the nutritional status; assist in guiding the care of catheter wounds, follow the principle of aseptic techniques, and avoid skin damage to prevent infection;Take active care, encourage patient present inner feelings, cooperate with the doctor to explain the procedure again to increase confidence, teach relaxation techniques and massage with essential oils to reduce anxiety. I hope that this care experience can provide a reference for clinical care of similar cases.
{"title":"照顧一位初次腹膜透析病人導管滲漏之照護經驗","authors":"楊馥妃 楊馥妃","doi":"10.53106/172674042023082102001","DOIUrl":"https://doi.org/10.53106/172674042023082102001","url":null,"abstract":"\u0000 本文描述一位罹患末期腎病病人初次接受腹膜透析治療因導管滲漏引發傷口皮膚不適及焦慮情緒之護理經驗。護理期間為2019年1月2日至2019年3月8日,筆者運用Gordon十一項健康功能評估為指引,透過直接照護、會談、觀察和查閱病歷等方式收集資料分析,確立個案有:營養狀況少於身體所需、潛在危險性感染及焦慮等健康問題。護理過程中,會診營養師並藉手機APP、衛教單張及影片來增進其對透析飲食的認知,以達到營養狀況改善;協助指導導管傷口的照護,遵守無菌原則換藥,避免皮膚受損預防感染發生;採取主動關懷,鼓勵說出內心感受,協同醫師說明再次手術過程增進信心,教導放鬆技巧及精油按摩,以減低焦慮感。希望此照顧經驗,能提供臨床照護類似個案之參考。\u0000 This article describes the nursing experience of a patient suffering from end-stage renal disease undergoing peritoneal dialysis for the first time because of catheter leakage caused by wound skin discomfort and anxiety. The nursing period is from January 2 to March 8,2019.The author used Gordon’s eleven health function assessments as a guide to collect data and analyze through direct care, interviews, observations, and medical records. The problems are as follows: Health problems such as nutritional status less than what the body needs, potentially dangerous infections and anxiety. During the nursing process, consult a nutritionist and use the mobile phone APP and Health Education Leaflet and video to enhance the cognition of dialysis diet, so as to improve the nutritional status; assist in guiding the care of catheter wounds, follow the principle of aseptic techniques, and avoid skin damage to prevent infection;Take active care, encourage patient present inner feelings, cooperate with the doctor to explain the procedure again to increase confidence, teach relaxation techniques and massage with essential oils to reduce anxiety. I hope that this care experience can provide a reference for clinical care of similar cases.\u0000 \u0000","PeriodicalId":31271,"journal":{"name":"Tai Wan Jiao Yu She Hui Xue Yan Jiu","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80074251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.53106/172674042023082102005
林姿妤 林姿妤, 劉詩吟 劉詩吟
本文旨在探討一位69歲血液透析個案面臨喪偶衝擊之護理經驗。護理期間自2020年2月24日至5月30日,筆者運用Gordon十一項健康功能型態為評估架構,藉由會談、傾聽、身體評估及實際照護方式收集資料,確立個案主要的健康問題為哀傷、睡眠型態紊亂及無效性健康維護能力,護理過程運用Worden哀傷輔導模式提供個別性照護,並與家屬一起協助個案表達內心感受及找尋生活的新動力;運用非藥物輔助療法,如:芳香療法、溫水足浴及調整生活型態,改善睡眠品質;另藉由評估個案對於高血磷的認知與態度,與家屬共同討論個別指導方式,加以提醒及修正個案自我照護行為,促使血磷控制於2.5-5.5 mg/dl正常範圍內。冀望藉此護理經驗能提供日後臨床血液透析護理同仁照護參考。 This article is about the nursing experience of a 69-year-old hemodialysis patient who was facing widowhood. The nursing period is from February 24th to May 30th, 2020. Assessment by Gordon’s 11 health functional patterns, the author collects information through talks, listening, physical evaluation and clinical care and make sure the main health problems of this patient as grief, sleep pattern disorders and ineffective health maintenance. I try to apply the Worden grief counselling model and works with family members to help this patient expressing her feelings and finding a new motivation for life. During this process, I apply adjuvant therapies, such as aromatherapy, foot bath with warm water and lifestyle adjustment to improve sleep quality. In addition of this, depending on her cognition and attitude of hyperphosphatemia I set up an individual care plan with family members and try to remind and correct her self-care behavior, and promot blood phosphorus control within the normal range of 2.5-5.5 mg/dl. I look forward to this nursing experience can provide reference for future clinical hemodialysis nursing care.
本文旨在探讨一位69岁血液透析个案面临丧偶冲击之护理经验。护理期间自2020年2月24日至5月30日,笔者运用Gordon十一项健康功能型态为评估架构,借由会谈、倾听、身体评估及实际照护方式收集资料,确立个案主要的健康问题为哀伤、睡眠型态紊乱及无效性健康维护能力,护理过程运用Worden哀伤辅导模式提供个别性照护,并与家属一起协助个案表达内心感受及找寻生活的新动力;运用非药物辅助疗法,如:芳香疗法、温水足浴及调整生活型态,改善睡眠品质;另借由评估个案对于高血磷的认知与态度,与家属共同讨论个别指导方式,加以提醒及修正个案自我照护行为,促使血磷控制于2.5-5.5 mg/dl正常范围内。冀望借此护理经验能提供日后临床血液透析护理同仁照护参考。 This article is about the nursing experience of a 69-year-old hemodialysis patient who was facing widowhood. The nursing period is from February 24th to May 30th, 2020. Assessment by Gordon’s 11 health functional patterns, the author collects information through talks, listening, physical evaluation and clinical care and make sure the main health problems of this patient as grief, sleep pattern disorders and ineffective health maintenance. I try to apply the Worden grief counselling model and works with family members to help this patient expressing her feelings and finding a new motivation for life. During this process, I apply adjuvant therapies, such as aromatherapy, foot bath with warm water and lifestyle adjustment to improve sleep quality. In addition of this, depending on her cognition and attitude of hyperphosphatemia I set up an individual care plan with family members and try to remind and correct her self-care behavior, and promot blood phosphorus control within the normal range of 2.5-5.5 mg/dl. I look forward to this nursing experience can provide reference for future clinical hemodialysis nursing care.
{"title":"運用哀傷輔導策略協助血液透析個案面臨喪偶衝擊之護理經驗","authors":"林姿妤 林姿妤, 劉詩吟 劉詩吟","doi":"10.53106/172674042023082102005","DOIUrl":"https://doi.org/10.53106/172674042023082102005","url":null,"abstract":"\u0000 本文旨在探討一位69歲血液透析個案面臨喪偶衝擊之護理經驗。護理期間自2020年2月24日至5月30日,筆者運用Gordon十一項健康功能型態為評估架構,藉由會談、傾聽、身體評估及實際照護方式收集資料,確立個案主要的健康問題為哀傷、睡眠型態紊亂及無效性健康維護能力,護理過程運用Worden哀傷輔導模式提供個別性照護,並與家屬一起協助個案表達內心感受及找尋生活的新動力;運用非藥物輔助療法,如:芳香療法、溫水足浴及調整生活型態,改善睡眠品質;另藉由評估個案對於高血磷的認知與態度,與家屬共同討論個別指導方式,加以提醒及修正個案自我照護行為,促使血磷控制於2.5-5.5 mg/dl正常範圍內。冀望藉此護理經驗能提供日後臨床血液透析護理同仁照護參考。\u0000 This article is about the nursing experience of a 69-year-old hemodialysis patient who was facing widowhood. The nursing period is from February 24th to May 30th, 2020. Assessment by Gordon’s 11 health functional patterns, the author collects information through talks, listening, physical evaluation and clinical care and make sure the main health problems of this patient as grief, sleep pattern disorders and ineffective health maintenance. I try to apply the Worden grief counselling model and works with family members to help this patient expressing her feelings and finding a new motivation for life. During this process, I apply adjuvant therapies, such as aromatherapy, foot bath with warm water and lifestyle adjustment to improve sleep quality. In addition of this, depending on her cognition and attitude of hyperphosphatemia I set up an individual care plan with family members and try to remind and correct her self-care behavior, and promot blood phosphorus control within the normal range of 2.5-5.5 mg/dl. I look forward to this nursing experience can provide reference for future clinical hemodialysis nursing care.\u0000 \u0000","PeriodicalId":31271,"journal":{"name":"Tai Wan Jiao Yu She Hui Xue Yan Jiu","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87807566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}