一位病患被診斷為急性呼吸窘迫症候群(ARDS)。下列哪些護理措施是適當的?(選所有適合的)
A client is diagnosed with acute respiratory distress syndrome (ARDS). Which nursing actions are appropriate? (Select all that apply.)
- AMaintain the client in a prone position✓ 正解維持病患採俯臥姿勢
- BAdminister high concentrations of oxygen✓ 正解給予高濃度氧氣
- CMonitor for pulmonary barotrauma✓ 正解監測肺臟氣壓創傷
- DMaintain strict fluid restriction嚴格限制液體攝取
- EPerform chest physiotherapy every 2 hours每兩小時進行胸部物理治療
ARDS 的處置重點在於透過俯臥位(Prone)改善肺部通氣血流灌流比(V/Q mismatch),並給予高濃度氧氣以改善缺氧。因需要使用呼吸器,需監測肺部氣壓傷(Barotrauma)。限水並非 ARDS 常規,反而需維持適當循環容量;胸腔物理治療對 ARDS 的瀰漫性肺水腫幫助有限。
Management of ARDS focuses on improving the ventilation-perfusion (V/Q) mismatch through prone positioning and administering high concentrations of oxygen to correct hypoxemia. Because mechanical ventilation is required, monitoring for pulmonary barotrauma is essential. Strict fluid restriction is not routine for ARDS; rather, adequate circulating volume must be maintained. Chest physiotherapy has limited benefit in the diffuse pulmonary edema of ARDS.
台灣加護病房推動俯臥位治療(Prone therapy)需耗費較多人力,美國通常設有專門翻身團隊。