一位草魚膽中毒導致急性肝腎毒性傷害患者之護理經驗

Nursing Experience of a Patient with Grass Carp Gallbladder Poisoning Experiencing Nephrotoxicity and Hepatotoxicity

10.6692/KJN-2013-30-2-6

何怡慧(Yi-Hui Ho)；蔡素華(Su-Hua Tsai)；楊麗玉(Li-Yu Yang)

草魚膽中毒 ； 急性腎衰竭 ； 體液容積過量 ； 焦慮 ； grass carp gallbladder poisoning ； acute renal failure ； fluid volume excess ； anxiety

高雄護理雜誌

30卷2期（2013 / 08 / 01）

63 - 71

繁體中文

本文描述一位草魚膽中毒導致急性腎衰竭伴隨肝毒性傷害患者之護理經驗，筆者於住院期間運用Gordon 11項健康功能評估，以觀察、會談收集資料，歸納個案主要有1、體液容積過量2、焦慮的健康問題。在照護期間提供專業知識及諮詢機會，指導執行各項措施；同時運用傾聽溝通等技巧，協助個案面對壓力與危機，調適初次住院卻得面臨血液透析治療等衝擊。藉由傾聽及關心了解其對透析真正的想法及感受，澄清觀念，加強家人支持系統的建立，協助個案改變對於血液透析的疾病詮釋，從一開始的拒絕治療到接受透析，以正向態度面對洗腎患者之角色，希望藉此報告與護理同仁分享經驗。

This article describes the nursing process of an acute renal failure with hepatotoxicity of a patient due to eating grass carp gallbladder. Both subjective and objective data were collected through Gordon's 11 functional assessment tools, observation, and interviews. The patient was confronted with fluid volume excess and anxiety.During the nursing process, individualized nursing care was provided by giving adequate information and offering the key points of interventions. In addition, listening and communication were provided to assist the patient in facing the pressure and crisis, and adjusting to the impact of hemodialysis.The author also assisted the patient through clarifying the viewpoints of hemodialysis, strengthening family support systems, and building up a positive attitude toward hemodialysis. In addition, continuing care and listening were also offered to the patient to change the interpretation of his illness. This case report aims to share the nursing experience and provide a reference for similar cases.