一位腰大肌膿瘍併發敗血性休克病人之加護經驗

A Nursing Experience for a Patient with Septic Shock Secondary to Psoas Abscess

腰大肌膿瘍是一種少見但致死率極高的後腹腔感染症。本文旨在描述照護一位腰大肌膿瘍併發敗血性休克病人於急診加護病房之護理經驗。護理期間為2009年3月26日至4月10日，筆者運用Gordon十一項功能性健康型態評估方式，透過身體評估、症狀觀察、醫療團隊討論等方式收集資料。確立個案有急性疼痛、高危險性感染、組織灌流改變、氣體交換障礙、焦慮等健康問題。筆者針對處於急性期的個案採行合宜的感染控制措施，監測血流動力學變化、維持呼吸導通暢等護理處置，致力維護個案生命徵象，並運用良好治療性人際關係，主動提供個案心理支持，以減輕治療過程中所引發的身心不適，且協助其渡過疾病危險期。期望本文協助個案生活適應之照護經驗與同儕分享，進而提升專業的照護品質。

Psoas abscess is a rare infection that occurs in the posterior abdominal cavity with an extreme high mortality rate. This paper describes a nursing experience for a patient in the acute intensive care unit with septic shock secondary to psoas abscess. The nursing period was from March 26 to April 10, 2009. Gordon's 11 Functional Health Patterns was applied for patient assessment. Data was collected based on the patient's physical assessment, observed symptoms, and the care team's discussion. Identified problems were acute pain, high risk for infection, ineffective tissue perfusion, insufficient gas exchange, and anxiety. The author took proper measures for infection control, monitored hemodynamic changes, and maintained airway patency for stabilization of vital signs. With a good therapeutic relationship, the author provided the patient with empathetic support with the intention of minimizing treatment discomfort during the critical stage. The purpose of sharing this nursing experience with nursing colleagues is promote the quality of professional care.