一位甲狀腺結節患者術後低血鈣之護理經驗

Nursing experience of postoperative hypocalcemia in a thyroid nodule patient

10.6647/CN.202003_27(1).0012

洪素敏(Su-Min Hong)；蕭淑娟(Shu-Chuan Hsiao)

甲狀腺全切除 ； 低血鈣症 ； 焦慮 ； total thyroidectomy ； hypocalcemia ； anxiety

彰化護理

27卷1期（2020 / 03 / 01）

97 - 106

繁體中文

本文為照顧一位因甲狀腺結節行甲狀腺全切除術，術後反覆出現低血鈣患者之護理經驗，筆者於患者住院期間2018/3/13～3/23，運用Gordon十一項健康功能型態，藉由觀察、會談、身體評估及病歷查閱等方式來評估個案生理變化及不適應行為，確立個案有1.潛在危險性損傷：低血鈣導致；2.潛在危險性血管損傷；3.焦慮等護理問題。藉由提供完善的照護措施，包括教導個案及家屬評估和及早識別低血鈣症狀，增進對疾病的認知及預防跌倒；減緩輸液注入速度與加強輸注時觀察，避免血管損傷；運用陪伴與傾聽建立信任性治療關係，鼓勵表達內心感受，並照會關懷師，進而減輕個案之焦慮，使個案能得到完善之照護。

This article is to take care of a nursing experience of patients with hypothyroidism after repeated thyroidectomy for thyroid nodules.The author was in the hospital during the hospitalization period 2018/3/13~3/23,Using Gordon's eleven health functions, assessing the physiological and incompetent behavior of the case through observation, interviews, physical assessment and medical record review.Established cases: 1. Potentially dangerous injuries: caused by low blood calcium; 2. Potentially dangerous vascular injuries; 3. Anxiety, and other nursing issues.By providing comprehensive care measures,Including teaching cases and family assessments and early identification of hypocalcemia symptoms, increasing awareness of the disease and preventing falls;Slow down the infusion rate and observe the infusion to avoid vascular injury;Use companionship and listening to establish a trusting treatment relationship, encourage expression of inner feelings, and pay attention to the care of the teacher, thereby reducing the anxiety of the case and enabling the case to be well protected.

1. Key, M., & Heering, H. (2017). Thyroidectomy: Providing Postoperative Care of the Patient Undergoing. CINAHL Nursing Guide . Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=nrc&AN=T707697&lang=zh-tw&site=nrc-live
2. Pemayun, T. G.(2016).Current diagnosis and management of thyroid nodules.Acta Med Indones,48(3),247-257.
3. Ross, D. S.(2017).,未出版
4. Schub, T., & Smith, N. (2018). Thyroidectomy. CINAHL Nursing Guide. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=nrc&AN=T700971&lang=zh-tw&site=nrc-live
5. Vallerand, A.,Sanoski, C.(2019).Davis´s Drug Guide for Nurses.
6. Walsh, K., & Kornusky, J. (2018). Hypocalcemia: Post-Thyroidectomy. CINAHL Nursing Guide. Retrieved from http://search.ebscohost.com./login.aspx?direct=true&db=nrc&AN=T702267&lang=zh-tw&site=nrc-live
7. Woten, M., &Balderrama, D. (2017). IV Therapy: Preventing Complications. CINAHL Nursing Guide. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=nrc&AN=T705644&lang=zh-tw&site=nrc-live
8. 徐莞雲,陳筱瑀(2008)。焦慮的概念分析。志為護理，7(3)，65-70。
9. 梁龙君,王玉艳(2017)。甲状腺全切术后的病情观察及并发症预防护理。中西医结合护理杂志，3(5)，158-159。
10. 曾敏峯,許育瑞(2017)。淺談低血鈣的成因與治療。腎臟與透析，29(1)，32-35。