照護一位初次接受放射線治療之肺癌個案護理經驗

The Nursing Experience in a Lung Cancer Patient First Time Radiation Therapy

10.6530/YYN.201811_12(3).0008

張郁敏(Yu-Min Chang)；李易靜(Yi-Chig Li)；張瓈方(Li-Fang Chang)

放射線治療 ； 肺癌 ； 營養 ； radiation therapy ； lung cancer ； nutrition

源遠護理

12卷3期（2018 / 11 / 01）

60 - 66

繁體中文

本文描述照護一位初次接受放射線治療肺癌個案，筆者2015年3月17日至4月6日照護此個案，因其疾病及接受放射線治療致使個案出現食慾不振、體力下降、發燒、肺炎及初次接受治療方式產生焦慮等並運用觀察、會談、身體檢查及Gorden十一項功能性評估確立個案健康問題：放射線治療造成氣體交換障礙、焦慮及本身疾病造成營養不均衡：少於身體需要等問題。採取措施包括：合適氧合、教導簡易肺部復健運動、腹式呼吸訓練，鼓勵個案攝取自己喜愛食物，共同擬定飲食攝取計畫，獲取足夠熱量及營養素，以維持身體所需；逐漸衛教放射線治療知識及自我照顧方式，採取傾聽、鼓勵、陪伴、關懷，其目的使個案能舒適及安全完成此階段放射線療程，返家後可自我照顧。期臨床護理人員及早評估及介入對初次接受相關疾病治療的知識與自我照顧技巧，減緩焦慮情緒，提升個案生活品質及護理照護品質。

This article describes the care of a lung cancer patient receiving his first cycle of radiotherapy between March 17 and April 6, 2015. The disease and radiation therapy caused the patient to experience a loss of appetite, physical decline, fever, pneumonia, and anxiety. Observations, interviews, physical examinations, and Gorden's 11 functional assessments were used to establish the patient's health problems that included: (1) gas exchange disorders due to radiotherapy, (2) anxiety, and (3) nutritional imbalances caused by diseases and less food intake than physical needs. Interventions included appropriate oxygenation, teaching simple lung rehabilitation exercise and abdominal breathing training. Jointly formulated were his diet plan to include his favorite foods with sufficient calories and nutrients to maintain his body's needs. Health education included proper radiation therapy information and self-care measures. The nurse' role were active listening, encouraging, companionship, and care. These measures enabled the patient to comfortably and safely complete the first stage of radiation therapy and subsequent care at home. Nurse's early intervention with the knowledge and self-care skills may alleviate patient's anxiety and improve the care and quality of life.

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