照顧一位末期腎病併發可逆性腦病變徵候群個案之護理經驗

A Nursing Experience of Assisting an ESRD Patient with Posterior Reversible Encephalopathy Syndrome

10.6974/TCNJ.201104.0091

吳慧萍(Hui-Ping Wu)；王首文(Shou-Wen Wang)

末期腎病 ； 角色緊張 ； 可逆性腦病變徵候群 ； 疲憊 ； end stage renal disease ； role strain ； encephalopathy syndrome ； fatigue

志為護理-慈濟護理雜誌

10卷2期（2011 / 04 / 01）

91 - 99

繁體中文

本文爲分享一位末期腎病行小腸局部切除後併發可逆性腦病變徵候群個案之護理經驗。護理期間自2009年4月22日至2009年7月15日，筆者進行身、心、靈及社會評估後，發現個案因急、慢性疾病長期住院，因感染及社交隔離，造成身、心、社會性疲憊，間接引發主要照顧者負荷而與個案間角色緊張等護理問題。當以關懷、陪伴、傾聽、身體清潔、提供諮詢及促進活動等護理措施後，使個案重拾信心及恢復獨立性功能，在病況穩定後轉慢性醫院持續進行治療，回歸原有社交生活。期提供此護理經驗爲照顧末期腎病併發可逆性腦病變徵候群個案之參考。

This article described the nursing process of assisting an ESRD post-surgery patient who had been admitted to hospital due to bladder cancer, but complicated with posterior reversible encephalopathy syndrome (PRES); the nursing period lasted from April 22nd to July 15th, 2009. Information was collected by interview and observation. Two main health problems were identified: fatigue and caregiver role strain, as the result of physical, psychological and social fatigue derived from long hospitalization and social isolation due to acute and chronic diseases. Through caring, accompanying, providing consultation and encouraging ambulation process, the patient not only adapted to the fatigue after surgery, but also regained functional independence. This nursing experience can help nursing staffs to thoroughly understand the reactions of ESRD Patients who are complicated with PRES, as well as providing a basis for an effective enhancement of the home care skills of the caregivers.