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This article describes an experience nursing a patient with recurrent cervical cancer. As a result of urinary leakage after radical surgery, the patient underwent a second anterior exenteration and ileo-conduit operation while experiencing emotional uncertainty. The nursing care involved a combination of direct care, home visits, telephone and OPD follow-up. Data collection and analysis followed via observation, conversation and the recording of behavioral processes. Nursing measures were taken to address the sense of threat induced by uncertainty and anticipatory grieving. We found the same sense of uncertainty that research has found to affect breast cancer patients, and found that it is similarly significantly higher pre-operation than post-operation. Besides providing information and supportive encouragement, nursing staff should evaluate the degree of uncertainty and the sources of support available to the patient, as well as improving nursing guidance for self-care. The support of family members, especially the spouse, is a form of positive feedback which may significantly reduce the degree of uncertainty.  相似文献   

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The case report presented a patient with dengue hemorrhagic fever after being bitten by an insect in a suburban area. The author observed and interviewed the patient and utilized Gorden's functional health scale to collect information, from Nov., 08 to Nov., 15 2002. Thrombocytopenia, febrile, and pain accompanied with dengue hemorrhagic fever were recorded during nursing evaluation. Lack of associated medical information contributed to the patient's anxiety status. The major nursing problems were changing of protection/ thrombocytopenia, hyperthermia, pain, and inadequacy of knowledge. The gum bleeding, fevers, and generalized bone pain were relieved by sincere listening and nursing intervention. In addition, medical information was delivered by way of a health information booklet to improve the understanding of the patient and ease the latter's anxiety status. Amid an increase in cases of dengue hemorrhagic fever in Taiwan, this case report might provide some valuable information to the nursing staff in order to enhance their ability to provide comprehensive care.  相似文献   

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The Peripherally Inserted Central Catheter (PICC) is still in its infancy in Taiwan. It has many advantages, including safety, simplicity, and few complications during the insertion process. It is suitable for patients who need long-term parenteral administration of medication or chemotherapy. However, the duration of PICC implantation is around six months, or even up to one year. As a result, it is very important to educate patients to take care of themselves throughout the implantation period in order to prevent complications. This report describes the experience of nursing a forty-four-year old male patient who suffered from acute lymphocytic leukemia and received a PICC implantation while undergoing chemotherapy treatment. As a PICC case manager, the author utilized self-efficacy theory and devoted herself to nursing care, interviews and phone calls to collect valuable information. During the process of PICC implantation, the author analyzed the characteristics of this case and assisted the patient and his primary care giver in choosing a suitable catheter and self-care techniques to achieve minimal complications during implantation. It is hoped that, by sharing in her experience, nursing staff may enhance their ability to assist patients with PICC and to help them to maintain their quality of life.  相似文献   

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静脉输液是目前护理工作中最常用的一项基本护理技术操作,在临床疾病的抢救、治疗和康复中占有重要地位,也是患者及家属最直观地评价护理工作质量和水平的依据。由此给护理工作人员提出一个重要课题即提高静脉穿刺技术。随着我国人口老龄化的进展,医院老年患者所占比例越来越大,且许多老年患者都是反复发病而多次人院,血管很难一次穿刺成功。老年人由于自身生理、心理状态异常,对静脉穿刺的成功与否尤为重视,这就要求护理人员具有过硬的技术水平。只有熟练掌握对老年患者的静脉穿刺技术,  相似文献   

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Amyotrophic lateral sclerosis (ALS) is a progressive and lethal motor neurodegenerative disease. The cause of the disease is unknown, and there is no cure current clinical treatment methods include Riluzole and supportive therapy. However, Riluzole only decelerates the patient's muscle strength loss and prolongs survival by about 3-5 months (Aventis Pharmaceutical, 2004). The patient will die eventually because of aspiration pneumonia or respiratory failure. This paper documents the use of Orem's self-care theory and holistic nursing assessment in a patient with amyotrophic lateral sclerosis. There are four areas of nursing concern: impaired self-care ability (dressing, feeding, toileting, and bathing), risk of falls, impaired verbal communication, and powerlessness. In terms of these problems suitable nursing activities are provided to develop the patient's ability to care for himself, prevent accidents, promote skills of non-verbal communication, and alleviate powerlessness in order to strengthen control.  相似文献   

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A seven-year old child was scheduled for excision of hemangioma under local anesthesia. Utilizing the concept of caring, we provided pre- and intra-operative support to both the patient and his mother. Before the operation, we effectively established the self-confidence of the patient by providing sufficient disease-related information and encouragement in a child-oriented approach, in order to enable the patient to overcome fear and pain. This caring approach proved effective during the operation since the patient was fully aware of each surgical step and the levels of pain to be experienced. The mother was also involved throughout the process. She was therefore not only emotionally pacified, but also actively involved in the psychosocial support process. Traditionally, almost all surgical procedures in pediatric patients have been performed under general anesthesia. This report indicates that under appropriate care some of the less invasive surgical procedures in school-age children can be carried out under local anesthesia to avoid the risks involved in general anesthesia.  相似文献   

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Suicidal patients admitted to hospital following a suicidal attempt or expressing suicidal ideation present a real challenge to health professionals with regard to their therapeutic Co. Antrim care. This study was undertaken to explore the attitudes of psychiatric nurses caring for such patients. Results reveal that psychiatric nurses do hold positive views on caring for potentially suicidal patients, contradicting previous studies where more negative feelings were expressed by nurses, especially those with initial contact. Findings also show that some nurses experience an element of distress, and the length of experience within such a working environment does not affect the nurses' level of satisfaction gained on caring for the suicidal patient. This study also identifies an expression of need for further education and practice in interpersonal skills and therapeutic modalities to enhance and develop a more effective delivery of care for this group of patients.  相似文献   

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Immersion practica have been used in a variety of nursing settings to help prepare culturally competent nursing students. The psychiatric setting represents a diverse culture that traditionally has not appealed to nursing students when considering career options. This article describes the experiences of baccalaureate nursing students and hospital nursing staff following a brief immersion practicum at a psychiatric facility. Seven students were assigned to one practicum for six consecutive weekdays (45 hours), without the distraction of other classes. Both the students and staff rated the experience as positive. The students believed that their ability to form therapeutic relationships, develop clinical skills, and integrate theory into clinical practice was enhanced. While nursing faculty struggle to produce more graduates, with declining clinical sites and increased competition for these sites, the brief clinical immersion may be a reasonable alternative to a traditional rotation.  相似文献   

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The purpose of this article is to describe a nursing experience with a patient with schizophrenia who had antipsychotics-induced overweight. The authors assessed the patient's health condition and provided weight management to reduce her hallucinations as well as her body weight between May 1 and June 10, 2004. Three nursing problems had been identified as follows: disturbed sensory perception, imbalanced nutrition, and ineffective health maintenance. During the nursing process, the authors established a rapport relationship with the patient and her mother, educated them in skills for reducing hallucinations, and designed an individual body weight management program. After the interventions, the patient was able to positively face her illness, effectively use methods to reduce the impact of hallucinations, and successfully lose 5.5 kg. From this perspective, an individual body weight management program can be an effective intervention for nurses to care for this group of patients.  相似文献   

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Educators face the dilemma of conveying didactic information in concise, creative ways that evoke critical thinking. In addition, high patient acuity, coupled with a growing nursing shortage, requires assimilation of didactic knowledge into sound clinical judgment in a timely manner. Human simulation offers a creative teaching modality that allows transference of textbook knowledge into a real-life situation where nursing students can function in their role without untoward effects to their clients. The author illustrates the use of a human birthing simulator, Noelle, in an undergraduate nursing program as a creative and effective teaching strategy.  相似文献   

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ABSTRACT:

This article gives an overview of a veterinary nurse's experience volunteering at the Esther Honey Foundation Animal Clinic in the Cook Islands. It highlights the daily routine for the clinic and staff on the tropical island and how it differed from working in a western type of environment, the amount of patients that were cared for and the type of treatments.  相似文献   

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With the growing incidence of infertility in the modern world, artificial fertilization techniques provide new hope for many would-be parents. However, side-effects of the treatment can have a huge impact on patients and their families. This article employs Roy's adaptation model to study a patient with ovarian hyperstimulation syndrome who had undergone artificial fertilization treatment. Under careful assessment and examination, the author discovered that the patient suffered from such problems as malnutrition, fluid overload, pain and lethargy, etc. By employing skillful communication techniques and the display of empathy, the author helped to alleviate the patient's sufferings during treatment, as well as providing professional knowledge and advice. To help the patient in resolving difficulties that might have been encountered in the family, the author also exercised the idea of the family as core. The author hopes to share the knowledge that, in the care of patients with infertility, it is vital that health care professionals look after their psychological requirements as well as their physical care, in order to provide optimum care.  相似文献   

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A fundamental issue that forensic psychiatric nurses struggle with is respect for patient autonomy, as the two liberal prerequisites for autonomy, liberty and rationality, are either absent or compromised in forensic psychiatric settings. In this paper, a contemporary feminist perspective of autonomy, relational autonomy, will be advanced as an alternative approach to the traditional liberalist, Kantian, perspective of autonomy. The concepts of autonomy, paternalism, and justice will be discussed in relation to forensic psychiatric nursing.  相似文献   

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