一位因洗腎感染C肝接受活體肝移植個案之手術全期護理經驗

A Perioperative Nursing Care Experience of a Living Donor Liver Transplanted Patient with Hepatitis C caused by Hemodialysis

10.29494/LN.202312_24(4).0006

陳靜怡(Jan-Yi Chen)；胡靜文(Ching-Wen Hu)；嚴美華(Mei-Hua Yen)

活體肝移植 ； 手術全期護理 ； C型肝炎 ； living-donor liver transplant ； perioperative nursing care ； hepatitis C

領導護理

24卷4期（2023 / 12 / 01）

67 - 82

繁體中文;英文

本文為一位洗腎罹患C型肝炎導致肝硬化，接受肝移植的63歲女性個案之手術全期護理。護理期間自2020年8月29日至9月7日，藉由會談、觀察、身體評估及查閱病歷收集資料，並運用Gordon十一項健康功能評估，確立個案有1.手術前焦慮2.潛在危險性損傷3.急性疼痛等健康問題。手術前主動提供相關手術室護理專業知識及技能，給個案及家屬心理支持和鼓勵；手術中維持手術過程皮膚完整性、無壓力性損傷、電灼傷及異物殘留體內；手術後與個案和家屬討論並教導減輕疼痛方法，正視個案的疼痛促使個案能平安順利度過手術，進而達到整體性手術全期護理目的，期望藉由此個案報告提供日後手術室護理師照護類似個案之經驗參考。

This article describes the perioperative nursing care experience for a 63 years old female patient who underwent liver transplantation as she suffered from liver cirrhosis caused by hepatitis C after renal dialysis. The data collected was by means of interview, observation, physical evaluation and medical records research from nursing period of August 29 to November 7 in 2020. The authors also applied Gordon's Eleven Functional Health Patterns to conduct an overall assessment. The patient was confirmed to encounter four major nursing problems: 1.preoperative anxiety, 2.underlying critical damage, and 3.acute pain. By actively provide nursing experience, knowledge, skill before the operation, and psychological support to encourage the case and their families. Maintain the integrity of skin during the operation, without pressure injury, electric burn and foreign body residues in the body. Post-operative pain control was discussed and educated the method of pain relief with the patient and the family members, so that the patient can go through the operation safely and smoothly as well as faceing her wound, therefore achieve the purpose of holistic surgery full-term care. It is hoped that this case report will provide a reference for the operating room nurses to care for similar cases in the future.

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