照顧一位濫用Ketamine行腸道膀胱擴大術後之護理經驗

Nursing Experience of Ketamine Abuse with Augmentation Enterocystoplasty Surgery Patient

10.6530/YYN.202103_15(1).0008

楊筑硯(Chu-Yen Yang)；孫吟蓁(Yin-Jhen Sun)

Ketamine濫用 ； 急迫性尿失禁 ； 自我因應能力缺失 ； Ketamine abuse ； acute urinary incontinence ； lack of self-response ability

源遠護理

15卷1期（2021 / 03 / 01）

59 - 65

繁體中文

長期使用Ketamine會造成膀胱損傷而引起尿失禁的症狀，產生膀胱炎的情形發生，即需透過手術切除的方式，甚至最後要接受洗腎的問題。本文系筆者照顧一位Ketamine濫用行腸道膀胱擴大術後的護理經驗，照護期間於2017年6月3日至2017年6月15日，筆者以羅氏（Roy's）適應模式做評估，透過溝通、身體評估及直接照護等相關資料的收集方式確立個案有急迫性尿失禁、急性疼痛、自我因應能力缺失之護理問題。依照病人健康問題，擬定個別性護理計畫，與病人建立良好的護病關係，針對病人生理問題教導使用骨盆底肌肉運動技巧及定期紀錄排尿日誌以改善尿失禁，現今手機是隨手可得的物品，運用內建下載喜愛音樂及與家人共同玩線上遊戲以轉移對疼痛的注意力，同時可增進家人之間的感情，協助找尋在地戒除Ketamine的資源及了解障礙因子，以順利遠離藥癮的困擾，進而增進自我因應能力。期許日後照顧此類病人時可提供更完整的護理措施之參考。

Long-term use of Ketamine can damage bladder, result in urinary incontinence, cystitis, may require surgical resection and eventual renal dialysis. This study describes the author's nursing experience of caring for a patient undergoing intestinal bladder augmentation due to Ketamine abuse from June 3 to June 15, 2017. The author used Roy's adaptation model for assessment. The author collected relevant data using communication, physical assessment, and direct care, to confirm that the patient's nursing problems, including acute urinary incontinence, acute pain, and lack of self-adjustment ability. According to patient's health problems, the author developed an individualized nursing plan and a good nurse-patient rapport. The author taught the patient proper use of pelvic floor muscle exercise techniques and a regular urination log to improve urinary incontinence. The use of a cell phone to hear music and play games to divert attention from pain, to improve the relationship among family members, to find local resources to quit Ketamine, to understand the barriers to stop drug addiction, and to improve self-response ability. The author hopes by sharing this research will result and may serve as a reference to provide more complete nursing measures for future care of similar patients.

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