Nursing Care of COVID-19 Patients with Acute Respiratory Distress Syndrome Using the FANCAS Nursing Concept: Two case studies
Keywords:
critical care nursing, covid-19, acute respiratory distress syndrome, FANCAS nursing conceptAbstract
The aim of this case study was to explore the application of the FANCAS nursing concept in the nursing process for COVID-19 patients with acute respiratory distress syndrome (ARDS). Two COVID-19 patients were selected from the Respiratory Intensive Care Unit at Suranaree University of Technology Hospital for the study. The FANCAS (Fluid balance, Aeration, Nutrition, Communication, Activity, Stimulation) Health Assessment Scale served as the patient assessment tool, and the data obtained underwent content analysis to provide a comprehensive explanation for each FANCAS category. Nursing care was then delivered to the patients based on their nursing diagnoses, adhering to the principles of the FANCAS nursing concept, as follows: 1) Fluid balance: Fluid and electrolyte imbalances, 2) Aeration: Oxygenation impairment due to reduced gas exchange efficiency, 3) Nutrition: Risk for malnutrition due to changes in dietary intake, 4) Communication: Inability to communicate or speak due to intubation, leading to anxiety, 5) Activity: Impaired personal hygiene and limitation of activity due to physical limitations or being on mechanical ventilation, and 6) Stimulation: Risk of septic shock and potential for transmission of the infection to others.
The study concluded that the FANCAS nursing concept can be efficiently and appropriately applied to the rapid and effective care of COVID-19 patients with ARDS. Both case studies yielded similar nursing diagnoses. Therefore, it is crucial for healthcare professionals to develop proficiency in assessing patients according to the FANCAS nursing concept in alignment with dynamic disease treatment approaches in clinical practice.
Downloads
References
Kirby T. Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities. Lancet Respir Med. 2020;8(6):547–8.
Department of Disease Control, Ministry of Public Health. Guidelines for Medical Practice, Diagnosis, and Treatment of Coronavirus Disease 2019 [internet]. 2020. [cited 2021 Oct 16]. Available from: https://ddc.moph.go.th/covid19-dashboard/ (in Thai)
Riou J, Althaus CL. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV). Euro Surveill. 2020;25(4):2000058.
Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43.
Hasan SS, Capstick T, Ahmed R, Kow CS, Mazhar F, Merchant HA, et al. Mortality in COVID-19 patients with acute respiratory distress syndrome and corticosteroids use: A systematic review and meta-analysis. Expert Rev Respir Med. 2020;14(11):1149-63.
Bernal JL, Andrews N, Gower C, Robertson C, Stowe J, Tessier E, et al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on Covid-19 related symptoms, hospital admissions, and mortality in older adults in England: Test negative case-control study. Siriraj med Bulletin. 2021;13(373):n10080.
Songmuang J. Acute respiratory distress syndrome. Siriraj Medical Bulletin. 2017;10(3):174-9. (in Thai)
Thongsan S. Case Study: Nursing care of corona virus 2019 with acute respiratory distress syndrome patient at Kalasin hospital. Journal of Health and Environmental Education. 2022;7(1): 108-119. (in Thai)
Holloway M. Nursing the Critically ILL Adult. California: Addison-Wesley; 1979.
Thongngam S, Phumoon S, Rattanarat R. Nursing care for patients with COVID-19 in the isolation ward Siriraj Hospital. Siriraj Medical Bulletin. 2020;13(3):81-90 (in Thai)
Kyranou M, Cheta C, Pampoulou E. Communicating with mechanically ventilated patients who are awake. A qualitative study on the experience of critical care nurses in Cyprus during the COVID-19 pandemic. PLoS One. 2022;17(12):1-20
Thanakijtummakul N. Nursing care for COVID-19 patients with acute respiratory distress syndrome. Thai Journal of Nursing Council. 2021;36(6):16-30. (in Thai)
Davidson AC, Banham S, Elliott M, Kennedy D, Gelder C, Glossop A, et al. BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults.Thorax 2016; 2016;71(Suppl 2):ii1-ii35
Piscoya A, Ng-Sueng LF, Parra del Riego A, Cerna-Viacava R, Pasupuleti V, Roman YM, et al. Efficacy and harms of remdesivir for the treatment of COVID-19: A systematic review and meta-analysis. PLoS One. 2020;15(12):1-19.
Vega ML, Dongilli R, Olaizola G, Colaianni N, Sayat MC, Pisani L, et al. COVID-19 pneumonia and ROX index: time to set a new threshold for patients admitted outside the ICU. Pulmonology 2021;27(5):475-6.
Suwattanapongchet T. Rama Co-RADS: Criteria for excluding abnormal levels from chest radiographs for diagnosis pneumonia in patients with confirmed COVID-19. Ramathibodi Medical Journal. 2021;44(2):50-62 (in Thai)
Othman EH, Shatnawi F, Alrajabi O, Alshraideh, JA. Reporting nursing interventions classification and nursing outcomes classification in nursing research: A systematic review. Int. Int J Nurs Knowl. 2020;31(1):19–36.
Chiaranai C, Petchprapai N, Chularee S, Waritorn P, Pongputiipat R, Khoabunmasiri S. Closed suction system in patients with artificial airway: A review of empirical evidence. Journal of Boromarajonani College of Nursing, Surin. 2020;8(1):82-93 (in Thai)
Parhar KKS, Zuege DJ, Shariff K, Knight G, Bagshaw SM. Prone positioning for ARDS patients-tips for preparation and use during the COVID-19 pandemic. Can J Anaesth. 2021;68(4):541-5.
Asghar E, Archibald M, Roshangar F. Nursing interventions for patients with COVID-19: A medical record review and nursing interventions classification study. Int. J. Nurs. Knowl. 2022;33:57-63.
Jarding EK, Makic MBF. Central line care and management: adopting evidence-based nursing interventions. J Perianesth Nurs. 2021;36(4):328-33.
Ling ML, Ching P, Apisarnthanarak A, Jaggi N, Harrington G, Fong SM. APSIC guide for prevention of catheter associated urinary tract infections (CAUTIs). Antimicrob Resist Infect Control. 2023;12(1):1-5.
Chang B, Frendl G, Aglio R, Lekowski R. Acute lung injury and acute respiratory distress syndrome. Essential Clinical Anesthesia Review: Keywords, questions and answers for the Boards. Cambridge: Cambridge University Press, England; 2015.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Journal of Nursing and Therapeutic Care
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
