- 期刊
照護一位罹患史蒂芬強森症候群老年病患的護理經驗
Caring for an Elderly Patient with Stevens-Johnson Syndrome
摘要
史蒂芬強森症候群（Stevens-Johnson Syndrome，SJS）為一種因用藥不當，造成高燒、紅疹、皮膚與黏膜出現如燒傷患者般廣泛性壞死之重症反應。如未能及早處理，死亡率高達三分之一。本文是描述一位自行服用過量巿售止痛劑，導致藥物不良反應造成全身72%嚴重的皮膚與黏膜受損，而引發史蒂芬強森症候群老年患者之照護過程。護理期間（2008年12月8日至2008年12月31日）透過傾聽、會談與身體評估等方式收集資料，發現其主要護理問題包括急性疼痛、皮膚與黏膜完整性受損、身體心像改變與用藥不當等問題。臨床照護，除緩解疼痛、維持皮膚完整性、建立正向身體心像等護理措施，協助適應疾病變化過程外，也協助該個案製作藥品使用手冊，改變其用藥行為，以預防個案因再次用藥不當而引發不良反應，期望此護理經驗對日後照顧此類個案之臨床護理同仁能有所助益。
並列摘要
Stevens-Johnson syndrome (SJS) is a severe idiosyncratic reaction most commonly triggered by medications. The illness is characterized by fever followed by the rapid onset of erythematous mucocutaneous lesions that may become necrotic. An elderly man developed SJS after using an over-the-counter drug. He had severe sloughing of the skin and mucous membranes. The author cared for the patient for 3 weeks. Based of Roy's adaptation model, information was collected by observation, interview, and physical assessment. Nursing problems identified included pain, lack of skin and mucous membrane integrity, changes in body image, and poor understanding of the proper use of medications. Nursing intervention included a medication manual and instruction to improve the patient's understanding of his own health. When caring for patients with SJS, understanding the cause of the syndrome may be helpful in providing appropriate information to the patient.
延伸閱讀
- 蔡靜蜜、陳素燕（2008）。一位史蒂芬強森症候群病人臨終照護經驗。榮總護理，25(1)，79-84。https://doi.org/10.6142/VGHN.25.1.79
- 莊依玫、韓玉蘭（2013）。照護一位格林－巴瑞症候群老人之護理經驗。長庚護理，24(1)，81-89。https://doi.org/10.6386/CGN.201303_24(1).0009
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- 林妤純、陳繪竹、王姮樺、陳遴鞠（2021）。Caring for an Elderly Patient of Prolonged Postoperative Recovery after Rectal Cancer Surgery。腫瘤護理雜誌，21()，49-60。https://doi.org/10.6880/TJON.202110/SP_21.05