| Supported Fowler Position |
支撑弗洛氏位 |
| 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. |
病人体位对保持身体正直至关重要。活动能力受损的病人都有出现挛缩、体位异常和褥疮等危险。护士负有减少这些危险的主要责任，它可以通过改变活动能力受损和感觉下降病人的体位来实现。 |
| 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. |
支撑弗洛氏位（半坐卧位）改善心排血量和通气作用，促进大小便排泄。在此体位时，病人床头升高45-60°，病人膝部略微抬高，这样，就不会出现下肢循环受限。病人在此体位时要通过支撑来保持身体的正直，从而全身舒适，减少身体系统损害的危险。 |
Potential Nursing Diagnoses Impaired physical mobility
Impaired skin integrity
Altered peripheral tissue perfusion |
潜在的护理诊断：生理活动能力受损
皮肤完整性受损
外周组织灌注改变 |
| Steps and Rationale |
步骤及说明 |
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、带手套。
* 减少微生物传播。
2. 病人仰卧，头靠近床头板。
* 防止床头抬高时病人滑向床尾。
3. 将床头抬高至45-60度角。
* 使病人更舒服，改善呼吸，增加社交、放松和看电视机会。 |
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. 将病人头部枕在床垫或小枕头上。
* 防止病人颈椎弯曲挛缩。
5. 如病人手和臂的自主控制和使用能力丧失，就用枕头支撑臂、手。
* 防止手臂未支撑时因下重作用牵拉引起肩膀脱位；防止静脉漩积，促进循环，减少手、臂水肿，防止腕部曲曲性挛缩。 |
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. 将枕头置于病人腰背部。
* 支撑腰椎，减少椎骨弯曲。
7. 将小枕头或布卷填于病人股部，如病人下肢麻木或无法控制下肢，可加用一个转子卷支撑股部。
* 防止膝盖过伸及身体压力引起的腰围动脉堵塞，转卷可以防止两腿外翻。 |
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. 在脚踝处放上小枕头或卷垫。
* 防止床垫对脚跟压力时间过长。
9. 在病人脚底放置搁脚板。
* 保持病人双脚处背曲位，减少足下垂。
10.脱手套、洗手。
* 减少细菌传播。
11.在护理记录上记录新体位。
* 记载所施操作。 |
| 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. |
护士注意事项如果枕头太高，病人在本体位时就有曲曲性挛缩的危险，其他并发症包括：髋部外翻、足下垂和骶骨及足跟皮肤破裂。 |
| 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. |
病人宣教本体位为教育病人自理、进行皮肤护理、用药常识等提供了极佳机会。 |
| 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. |
老人由于毛细血管变脆、肌肉功能下降、皮肤干燥等原因，老年病人的皮肤破裂危险要大于年轻病人。 |
