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題名:照顧一位初次接受血液透析的茹素病人之護理經驗
書刊名:長庚護理
作者:林姵妘
作者(外文):Lin, Pei-yun
出版日期:2017
卷期:28:3=99
頁次:頁562-573
主題關鍵詞:初次血液透析茹素無望感First-time hemodialysisIntake vegetarian foodHopelessness
原始連結:連回原系統網址new window
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  • 共同引用共同引用:23
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本文旨在描述照護一位初次接受血液透析個案,因攝取蛋奶素導致低蛋白與高血磷的問題,同時因面臨透析產生無望感之護理經驗。護理期間為西元2015 年4 月24 日至7 月3 日,筆者藉由觀察、會談、傾聽、檢閱病歷等方式收集資料,並以Gordon 十一項健康功能評估進行整體性評估及分析,確立護理問題為:潛在危險性感染、營養不均衡:少於身體需要、無望感。照護過程中,筆者運用主動關懷,先與個案建立良好信任關係,再經序漸進予護理指導,運用手機撥放影片來教導暫時性雙腔靜脈導管傷口照護技巧;收集個案飲食習慣後與個案共同討論修正飲食採高蛋白低磷飲食,並協助製作「磷/蛋白質」比值小於20 的茹素食譜等;此外,在面臨透析而感到無助時,適時陪伴與提供心理支持,傾聽並瞭解其需求,鼓勵其表達內心感受,坦然面對生活進而重建正向人生觀,並重新規劃未來生活的藍圖。
This paper describes the nursing experience of taking care of a patient who receives the hemodialysis treatment for the first time and has low protein and hyperphosphatemia problems because of lacto-ovo vegetarian eating habit. The felt hopeless while receiving hemodialysis treatment. The nursing period started from the 24th of April the 3rd of July in 2015. Data were collected through physical observation, interview,listening, and medical Records review. Overall assessment and analysis were carried out by use of Gordon eleven functional health assessment. The nursing problems inlcuded potential risk of infection, imbalanced nutrition-less than body needs, and hopelessness. During the nursing, active cares were utilized to establish a good trust relationship with the patient and nursing guides were provided gradually. The author used videos played by a cell phone to teach the patient how to take care of temporary duallumen catheter wound. The author discussed eating habits with the patient and suggested how to modify the diet to a high-protein and low-phosphorus one, assisting the patient to to recreate vegetarian recipes with a "phosphorus/protein" ratio less than 20. Moreover, when the patient felt helpless while receiving hemodialysis treatment, the author provided timely accompany and psychological support, listened and understood the patient’s needs, and encouraged the patient to express the feelings, to face the reality of life, to rebuild a positive view of life, and to re-plan for the future.
期刊論文
1.蘇淑芬、陳靖博(20000200)。暫時性雙腔血液透析靜脈導管之護理。腎臟與透析,12(1),43-45。  延伸查詢new window
2.劉月敏、劉湘俐、駱敏淑、馬麗卿、張宏哲(20100600)。血液透析患者的復原力與社會支持。臺灣腎臟護理學會雜誌,9(1),33-43。  延伸查詢new window
3.Pronovost, P.、Needham, D.、Berenholtz, S.、Sinopoli, D.、Chu, H.、Cosgrove, S.、Sexton, B.、Hyzy, R.、Welsh, R.、Roth, G.、Bander, J.、Kepros, J.、Goeschel, C.(2006)。An intervention to decrease catheter-related bloodstream infections in the ICU。The New England Journal of Medicine,355(26),2725-2732。  new window
4.吳紅蓮、楊麗芬、許薳尹、王郁薇、周雪琦、徐瑋婷(20100800)。慢性腎臟病控制高血磷的飲食知識與衛教技巧。腎臟與透析,22(3),206-209。  延伸查詢new window
5.李秋香、顏文娟、黃秀梨(20090600)。無望感之概念分析。嘉基護理,9(1),7-11。  延伸查詢new window
6.蘇清菁、陳玉敏(20091200)。無望感之概念分析。長庚護理,20(4)=68,456-462。new window  延伸查詢new window
7.吳紅蓮(20141100)。腹膜透析病患高血磷飲食治療之策略--黃豆蛋白之應用。腎臟與透析,26(4),269-275。  延伸查詢new window
8.陳妙佩、陳建文、蕭善良、毛鴻忠(20120200)。長期血液透析病患鈣磷控制與副甲狀腺素濃度的關聯性分析。腎臟與透析,24(1),54-58。  延伸查詢new window
9.陳慧芬(20131100)。血液透析病患之素食飲食原則與常見的營養問題。腎臟與透析,25(4),320-324。  延伸查詢new window
10.黃文德、朱柏齡、許育瑞(20140600)。磷結合劑在慢性腎臟疾病病人運用的新進展。內科學誌,25(3),184-194。  延伸查詢new window
11.黃勝梅、王素琴、林秀慧、邱百群(20140900)。血液透析病患雙腔靜脈導管感染率改善專案。臺灣腎臟護理學會雜誌,13(3),41-56。  延伸查詢new window
12.葉哲廷、楊五常、吳采虹(20111100)。血管通路之綜論與比較。腎臟與透析,23(4),256-261。  延伸查詢new window
13.De Andrade, D.、Ferreira, V.(2007)。Central venous access for haemodialysis: prospective evaluation of possible complications。Journal of Clinical Nursing,16(2),414-418。  new window
14.Noori, N.、Kalantar-Zadeh, K.、Kovesdy, C. P.、Bross, R.、Benner, D.、Kopple, J. D.(2010)。Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients。Clinical journal of the American Society of Nephrology,5(4),683-692。  new window
15.Uribarri, J.(2007)。Phosphorus homeostasis in normal health and in chronic kidney disease patients with special emphasis on dietary phosphorus intake。Seminars in Dialysis,20(4),295-301。  new window
圖書
1.丁彥伶、吳佩琪(2014)。植物蛋白質的神奇力量。臺北市:遠見天下文化出版股份有限公司。  延伸查詢new window
2.陳漢湘、徐于淑、李婉萍(2012)。洗腎飲食全書。臺北市:原水文化。  延伸查詢new window
3.許志成(2014)。臺灣腎病年報。臺北市:衛福部。  延伸查詢new window
 
 
 
 
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