One patient with thoracic deformity combined with spontaneous pneumothorax complicated with type II respiratory failure was cared for using the Roy adaptation model
运用Roy适应模式护理1例胸廓畸形合并自发性气胸并发Ⅱ型呼吸衰竭患者

摘要

总结1例青年男患、胸廓畸形10余年，突发呼吸困难，胸部CT提示双侧自发性闭合性气胸，动脉血气分析提示Ⅱ型呼吸衰竭，需使用无创呼吸通气，并兼顾气胸吸收的护理体会，入院后运用Roy适应模式护理，通过调节患者生理、心理适应行为，应对疾病压力源，结合肺康复核心要素，为患者拟定护理问题，制定护理计划，实施针对性的个性化护理干预，通过实施呼吸支持与氧疗管理、气道管理与抗感染、病情监测与并发症预防、营养支持与活动指导、心理护理与健康教育等方面总结护理经验，患者呼吸困难症状改善，SPO2维持在95%以上，血气分析指标改善、可有效咳嗽、咳痰，感染指标下降，掌握呼吸训练方法，焦虑情绪缓解，双侧气胸减少，经过积极的治疗与护理，患者住院14天后，好转出院。

Abstract

Summarize the nursing experience of a young male patient with thoracic deformity for more than 10 years, sudden dyspnea, bilateral spontaneous closed pneumothorax indicated by chest CT, and type II respiratory failure indicated by arterial blood gas analysis. Non-invasive respiratory ventilation was required, and the absorption of pneumothorax was also taken into account. After admission, the Roy adaptation model was used for nursing. By adjusting the patient's physiological and psychological adaptation behaviors, the disease stress sources were dealt with. Combined with the core elements of pulmonary rehabilitation, nursing problems were formulated for patients, nursing plans were developed, and targeted personalized nursing interventions were implemented. Through the implementation of respiratory support and oxygen therapy management, airway management and anti-infection, condition monitoring and complication prevention, nutritional support and activity guidance, psychological care and health education, etc., nursing experiences were summarized, and the symptoms of breathing difficulties of patients improved. SPO2 was maintained above 95%, blood gas analysis indicators improved, effective coughing and expectoration were possible, infection indicators decreased, respiratory training methods were mastered, anxiety was relieved, bilateral pneumothorax was reduced. After active treatment and care, the patient improved and was discharged after 14 days of hospitalization.