照顧一位呼吸窘迫症候群病人採俯臥治療之護理經驗

Nursing Experience from Caring a Patient with Acute Respiratory Distress Syndrome Treated in Prone Position

10.29494/LN.202203_23(1).0006

莊琇媚(Hsiu-Mei Chuang)；郭雅芬(Ya-Fen Kuo)；李美淑(Mei-Shu Li)；陳姝年(Chu-Nien Chen)

呼吸窘迫症候群 ； 俯臥治療 ； acute respiratory distress syndrome(ARDS) ； prone position

領導護理

23卷1期（2022 / 03 / 01）

63 - 75

繁體中文

呼吸窘迫症候群是急重症單位常見的診斷之一，文獻顯示俯臥治療的確可改善該類病人的氧合狀況並降低死亡率。本文描述一位82歲女性因吸入性肺炎併呼吸窘迫症候群，入住加護病房接受俯臥治療之護理經驗。護理期間自2019年06月09日至2019年06月22日，運用Gordon十一項功能性健康型態評估為工具，彙整評估結果，發現個案有氣體交換障礙、潛在危險性皮膚完整性受損、焦慮等健康問題。運用俯臥治療及胸腔復健運動，來維持良好的血液動力學，進而達成移除氣管內管之目標；俯臥治療期間提供舒適擺位及減壓輔具，避免產生壓力性損傷；以正向鼓勵引導個案表達感受，連結家屬的支持力量來增加個案自我信心，使個案在心理焦慮層面得以調適。藉由此次個案的照護經驗，提供日後護理人員照護俯臥治療病人之參考。

Acute Respiratory Distress Syndrome (ARDS) is one of the common diagnoses in the Intensive Care Unit (ICU). Previous studies showed prone position can indeed improve the oxygenation status of such patients and reduce the mortality rate. This study describes nursing experience of an 82-year-old female patient with aspiration pneumonia and ARDS when admitted to ICU. During the nursing period, from June 9 to June 22 in 2019, staff applied the Gordon 11 Function Health Patterns Assessment and revealed that the case had health issues such as gas exchange impairment, potential damage of skin integrity, and anxiety. By applying prone position and chest physical therapy to maintain good hemodynamics and therefore achieve the goal of removing the endotracheal tube; Provide comfortable positioning and decompression aids during prone treatment to avoid pressure injuries; Positive encouragement to guide the case to express emotions and connect support of family members to increase self-confidence and help the case to alleviate her anxiety. Based on the nursing experience from this case, provide a nursing reference for taking care of patients with prone position in the future.

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