| Supported Fowler Position | 支撐弗洛氏位 |
| Correct positioning of a client is crucial for maintaining proper body alignment. Any client with impaired mobility is at risk of developing contractures, postural abnormalities, and pressure sores. The nurse has the primary responsibility to minimize this risk, which is done by changing the position of the client experiencing impaired mobility and decreased sensation at frequent intervals. | 病人體位對保持身體正直至關(guān)重要?；顒幽芰κ軗p的病人都有出現(xiàn)攣縮、體位異常和褥瘡等危險。護士負有減少這些危險的主要責(zé)任，它可以通過改變活動能力受損和感覺下降病人的體位來實現(xiàn)?！?/td> |
| The supported Fowler position improves cardiac output and ventilation and facilitates urinary and bowel elimination. In this position the head of the client's bed is raised 45 to 60 degrees, and the client's knees are slightly elevated so no restriction of circulation to the lower extremities occurs. Proper alignment of the body when the client is in this position requires support that maintains comfort and reduces the risk of damage to body systems. | 支撐弗洛氏位（半坐臥位）改善心排血量和通氣作用，促進大小便排泄。在此體位時，病人床頭升高45-60°，病人膝部略微抬高，這樣，就不會出現(xiàn)下肢循環(huán)受限。病人在此體位時要通過支撐來保持身體的正直，從而全身舒適，減少身體系統(tǒng)損害的危險?！?/td> |
Potential Nursing Diagnoses Impaired physical mobility
Impaired skin integrity
Altered peripheral tissue perfusion | 潛在的護理診斷：生理活動能力受損
皮膚完整性受損
外周組織灌注改變 |
| Steps and Rationale | 步驟及說明 |
1. Wash hands and don gloves （if appropriate）.
* Reduces transmission of microorganisms.
2. Position client supine with his head near headboard.
* Prevents client from sliding toward foot of bed when head of bed is elevated.
3. Elevate head of bed 45 to 60 degrees.
* Increases client comfort, improves breathing, and increases his opportunity to socialize, relax, or watch television. | 1. 洗手、帶手套。
* 減少微生物傳播。
2. 病人仰臥，頭靠近床頭板。
* 防止床頭抬高時病人滑向床尾。
3. 將床頭抬高至45-60度角。
* 使病人更舒服，改善呼吸，增加社交、放松和看電視機會?！?/td> |
4. Rest client's head against mattress or on very small pillow.
* Prevents flexion contracture of client's cervical vertebrae.
5. Use pillows to support client's arms and hands if he does not have voluntary control or use of arms and hands.
* Prevents shoulder dislocation from downward gravitational pull of unsupported arms, promotes circulation by preventing venous pooling, reduces edema in arms or hands, and prevents flexion contractures of wrist. | 4. 將病人頭部枕在床墊或小枕頭上。
* 防止病人頸椎彎曲攣縮。
5. 如病人手和臂的自主控制和使用能力喪失，就用枕頭支撐臂、手。
* 防止手臂未支撐時因下重作用牽拉引起肩膀脫位；防止靜脈漩積，促進循環(huán)，減少手、臂水腫，防止腕部曲曲性攣縮?！?/td> |
6. Position pillow at client's lower back.
* Supports lumbar vertebrae and decreases flexion of vertebrae.
7. Place small pillow or roll under client's thighs. If his lower extremities are paralyzed or he is unable to control lower extremities, use a trochanter roll in addition to a pillow under his thighs.
* Prevents hyperextension of, knees and occlusion of popliteal artery caused by pressure from body weight. Trochanter roll prevents external rotation of legs. | 6. 將枕頭置于病人腰背部。
* 支撐腰椎，減少椎骨彎曲。
7. 將小枕頭或布卷填于病人股部，如病人下肢麻木或無法控制下肢，可加用一個轉(zhuǎn)子卷支撐股部。
* 防止膝蓋過伸及身體壓力引起的腰圍動脈堵塞，轉(zhuǎn)卷可以防止兩腿外翻?！?/td> |
8. Place small pillow or roll under ankles.
* Prevents prolonged pressure on heels from mattress.
9. Place footboard at bottom of client's feet.
* Maintains feet in dorsiflexion. Reduces risk of foot-drop.
10. Remove gloves and wash your hands.
* Reduces transmission of microorganisms.
11. Record in nurse's notes client's new position.
* Documents that procedure was performed. | 8. 在腳踝處放上小枕頭或卷墊。
* 防止床墊對腳跟壓力時間過長。
9. 在病人腳底放置擱腳板。
* 保持病人雙腳處背曲位，減少足下垂。
10.脫手套、洗手。
* 減少細菌傳播。
11.在護理記錄上記錄新體位。
* 記載所施操作。 |
| Nurse AlertClients in the Fowler position are at risk of cervical flexion contractures if the pillow is too thick. Additional complications may include external rotation of the hips, foot-drop, and skin breakdown at the sacrum and heels. | 護士注意事項如果枕頭太高，病人在本體位時就有曲曲性攣縮的危險，其他并發(fā)癥包括：髖部外翻、足下垂和骶骨及足跟皮膚破裂?！?/td> |
| Client TeachingThe Fowler position provides an excellent opportunity for the nurse to implement client teaching in self-care （as with the newly diagnosed diabetic client）, skin care, and knowledge about medications. | 病人宣教本體位為教育病人自理、進行皮膚護理、用藥常識等提供了極佳機會。 |
| Geriatric ConsiderationsElderly clients are at greater risk than are younger clients of skin breakdown because of increased capillary fragility, decreased muscle mass, and reduced skin moisture. | 老人由于毛細血管變脆、肌肉功能下降、皮膚干燥等原因，老年病人的皮膚破裂危險要大于年輕病人?！?/td> |
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