運用持續性幫浦餵食一位腹壁裂合併低出生體重兒之護理經驗

A Nursing Experience of Persistent Feeding of a Neonate Suffering from Gastroschisis Complicated with Low Birth Weight

許惠昭(Hui-Chao Hsu) ； 黃小萍(Hsiao-Ping Huang) ； 許惠玲(Hui-Ling Hsu) ； 陳宜綸(I-Lun Chen)

《志為護理-慈濟護理雜誌》 12卷6期 (2013/12) Pp. 108-117

摘要

本文描述一位腹壁裂合併低出生體重兒運用持續性幫浦餵食的護理經驗，2011年5月5日至2011年5月29日護理過程中，藉由系統性評估及直接護理，依Gordon十一項功能性健康評估進行資料收集及確立護理問題有：營養不均衡少於身體所需、急性疼痛及潛在危險性父母。針對護理問題提供適當及個別性照護，協助護理問題獲得改善，包括因腹壁裂造成餵食不耐期間，利用持續性幫浦餵食轉成一次足量由口餵食；傷口疼痛，給予非營養性吸吮及寧握護理等達疼痛緩解；在父母面對疾病壓力調適及依附關係改變，共同制定照護計畫，提供相關資源，增進照護技能及親子依附關係，藉此照護經驗供護理人員照顧類似個案之參考，提供適切的照護及品質。

關鍵字

腹壁裂 ； 持續性幫浦餵食 ； 低出生體重兒

並列摘要

This study presented a nursing experience of applying a persistent feeding pump on a neonate with gastroschisis and low birth weight. The nursing period lasted from From May 5th to May 29th, 2011. With Gordon 11 Function Health Patterns as framework, we collected and analyzed data through systemic reviewing and direct care. The nursing problems of this case were: 1) nutritional imbalance and deficiency; 2) acute pain; 3) potentially dysfunctional parents. A nursing plan, drafted in accordance to the aforementioned nursing issues to provide an appropriate and individual care, included the following: 1) apply persistent feeding pump, and later replaced with bolus feeding, to accommodate feeding intolerance ensuing gastroschisis repair; 2) apply containment and non-nutritive sucking for acute pain relief; and 3) jointly draft a care plan with the parents and provide associated information as they faced the change in attachment relationship with their child and the pressure of the disease's course, to enhance the parents' care technique and restore the child-parent relationship. We hope that this nursing experience could serve as a reference for other nursing staffs when attending to similar to provide appropriate quality care.

並列關鍵字

gastroschisis ； low birth weight ； persistent feeding