照顧一位福爾尼埃氏壞疽患者之護理經驗

The Experience of Nursing Care for a Fournier's Gangrene Patient

周彥君(Yen-Chun Chou)；盧美玲(Mei-Ling Lu)；陳曉梅(Hsiao-Mei Chen)

福爾尼埃氏壞疽 ； 感染 ； 疼痛 ； 活動功能障礙 ； Fournier's gangrene (FG) ； infection ； pain ； impaired physical mobility

若瑟醫護雜誌

14卷1期（2020 / 07 / 01）

123 - 135

繁體中文

本文描述一位因下腹部及肛門旁有福爾尼埃氏壞疽（Fournier's gangrene, FG）感染進行多次手術及面臨身、心、社會衝擊個案之護理經驗。護理期間自2018年9月8日至2018年9月26日筆者運用Gordon十一項健康功能型態進行評估，以會談、觀察及身體評估進行資料收集，確立個案問題有：現存性感染、活動功能障礙、急性疼痛、焦慮等健康問題。護理過程中依標準無菌技術執行換藥、每日評估傷口；使用輔助器具協助日常生活自理及會同復健師擬定適合之運動；提供減輕疼痛的方法與技巧；給予傷口進展解說，運用同理心與建立良好的護病關係減輕焦慮與不安，並鼓勵家屬陪伴，共同克服疾病與手術所帶來的衝擊，使個案能儘早回歸日常生活，期望透過此照護經驗，提供臨床實務照護此類似個案之參考。

This article describes a nursing experience caring for a patient who was infected with Fournier's gangrene (FG), had wounds in the lower abdomen and beside the anus and underwent multiple surgeries while facing physical, mental and social impacts. The period of care was from September 8 to September 26 in 2018. Gordon's 11 functional health patterns were applied for overall assessment. Data were collected through interviews, observation and physical assessments. The health problems identified were existing infection, impaired physical mobility, acute pain and anxiety. During the nursing period, the dressing was performed in accordance with the standard aseptic technique and the wound healing condition was evaluated every day; assistive device was used to assist the patient with self-care and suitable exercise for rehabilitation was also developed with the rehabilitation therapist; the method and technique of relieving pain was provided; explanation of the wound healing process was also given, empathy was expressed to establish a good nurse-patient relationship to alleviate the patient's anxiety and restlessness, family members were also encouraged to accompany the patient to overcome the impact of the disease and surgery so that the patient could return to the normal life as soon as possible. It is hoped that this care experience can serve as a reference for clinical nursing practice in the care of similar patients.

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