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照顧一位壞死性筋膜炎致敗血性休克病人之加護護理經驗

Nursing Experience of a Necrotizing Fasciitis Patient with Septic Shock in the ICU

摘要


本文探討一位因下肢壞死性筋膜炎致敗血性休克合併多重器官衰竭的病人,於術後轉入加護病房之照護經驗。於加護病房期間,筆者運用Gordon十一項健康功能型態評估,採直接護理、觀察、與病人及其家屬會談等技巧整體性評估,發現病人健康問題為現存性感染、氣體交換障礙、體液容積過量及無望感等;護理過程以密切監控血流動力學及傷口護理協助病人渡過敗血症,因不預期的身體改變,使病人對未來產生負面的看法導致無望感,運用同理心及關懷的態度,與家屬共同協助病人渡過危機,並以此個案分享。

並列摘要


This article explores the experience of post-operation care of a patient suffering from septic shock with multiple organ failure causedby lower limb necrotizing fasciitis in an intensive care unit. During the period, the author used Gordon 11 functional health pattern assessment, to adopt the direct care, observation, meeting with patients and their families by using holistic assessment in the ICU. The patients had health problems such as existing infection, gas exchange impairment, body fluid volume excessiveness, and hopelessness. The nursing process closely monitored the hemodynamics and wound care to help the patient survive from sepsis. The patient felt hopeless toward the future. Using empathy and caring attitude helps the patients through the crisis.

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