照護一位糖尿病病人使用生酮飲食合併急性胰臟炎之護理經驗

Nursing Experience of a Patient with Diabetes on a Ketogenic Diet Complicated with Acute Pancreatitis

徐子婷(Tzu-Ting Hsu)；蔡惠如(Hui-Ju Tsai)；江怡瑩(I-Ying Chiang)；孫國紹(Kuo-Shao Sun)

糖尿病 ； 生酮飲食 ； 急性胰臟炎 ； acute pancreatitis ； diabetes ； ketogenic diet

志為護理-慈濟護理雜誌

20卷4期（2021 / 08 / 01）

78 - 87

繁體中文

生酮飲食療法若未經審慎評估風險後使用易引發高血脂、酮酸中毒等風險。本文描述一位42歲糖尿病人使用生酮飲食引發急性高血酯導致胰臟炎之護理經驗。護理期間自2018年4月3日至4月16日，經由直接照護、身體評估、觀察、開放性會談等方式收集資料，並以Gordon十一項功能性健康型態評估分析歸納其主要健康問題為組織灌流改變、疼痛及焦慮。照護期間主動關懷與陪伴，運用傾聽及不批判的溝通技巧建立良好護病關係，利用簡易器官及血液循環圖卡向家屬解釋急性胰臟炎與生酮飲食之相關性，與個案建立治療目標及信任感，協助個案解除焦慮增強自我飲食控制，期望藉此護理經驗提供護理人員照護此類病人之參酌。

A ketogenic diet leads to hidden health concerns such as inducing hyperlipidemia and ketoacidosis when there is improper and careless risk evaluation. The objective of this article was to describe the nursing experience of a 42-year-old male patient with diabetes on ketogenic diet, which was further complicated with hyperlipidemia-related acute pancreatitis. The nursing period was from April 3, 2018 to April 16, 2018. We collected the data from different methods such as direct care, physical assessment, observations during nursing care and so on. We applied Gordon's 11-itemed functional health patterns to assess, analyze, and summarize the main health problems, namely tissue perfusion changes, pain, and anxiety, faced by the subject. The active care and companionship during the nursing process with attentive listening and non-criticizing communication techniques was crucial to build a favorable relationship. We used simple human body organ and blood circulation charts to explain the physiological relationship between acute pancreatitis and ketogenic diet. We established the treatment goals with the patient and family members, and also helped in building trust, relieving anxiety, and increasing self-control. We hope this experience will be useful for the nursing staff while serving as a reference for similar cases in the future.

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