照護一位食道閉鎖合併十二指腸閉鎖新生兒之急性期護理經驗

A Nursing Experience of A Newborn with Combined Esophageal and Duodenal Atresia in the Acute Stage

陳秋妏(Chiou-Wen Chen)

《志為護理-慈濟護理雜誌》 11卷4期 (2012/08) Pp. 109-118

https://doi.org/10.6974/TCNJ.201208.0109

摘要

本文探討一位食道閉鎖合併十二指腸閉鎖之新生兒於出生後緊急手術的照護過程，於2009年09月26日至2009年10月16日，透過直接照護及與個案父母互動收集資料，以系統性整體評估個案健康問題與個案父母情緒，主要有：潛在危險性肺吸入、潛在危險性損傷、混亂性嬰兒行為、營養狀態少於身體所需、照顧者角色緊張等。提供個案呼吸道照護，預防手術前肺部感染及減少手術後修補處滲漏等合併症，運用發展性支持照護，減輕個案手術後壓力，達到自我舒適調節，鼓勵父母執行袋鼠護理及參與個案照護。

關鍵字

食道閉鎖 ； 十二指腸閉鎖 ； 發展支持性照護

並列摘要

This article described the nursing process of a newborn who underwent an urgent surgery after being diagnosed with combined esophageal atresia and duodenal atresia. The nursing care period lasted for three weeks, from September 26 to October 16, 2009. Relevant information was collected through direct care and interaction with the case's parents. A systematic overall assessment was conducted on the case was, , focusing on both the case's potential health risks and his parental emotions. The major nursing problems were: potential risky injuries; disorganized infant behavior; insufficient nutrition and caregiver role strain. We drafted a nursing plan to address the issues, providing respiratory care to prevent any pre-surgical pulmonary infection and to reduce post-surgical complications, such as leakages at repairs; employing developmental care to relieve the case's post-surgical discomfort and stress and to help the patient achieve spontaneous relief and adjustment. To help implement the family-centered care project, the case's parents were encouraged to carry out ”kangaroo care” and to involve in case care.

並列關鍵字

developmental care ； duodenal atresia ； esophageal atresia