一位安胎失敗產婦早產護理經驗

Nursing Experience of a Mother with Premature Labor due to Tocolysis Failure

蔡碩心(Shuo-Shin Tsai) ； 柯貞如(Chen-Ju Ko)

《馬偕護理雜誌》 2卷1期 (2008/01) Pp. 59-69

https://doi.org/10.29415/JMKN.200801_2(1).0006

摘要

本文主要在描述一位面臨安胎過程不適及安胎失敗早產產婦之護理經驗，護理期間為2006年8月28日至2006年9月17日，運用Gordon十一項功能性健康型態評估為主軸，另以身體評估、會談、觀察等方法收集、分析資料，確立個案安胎期間護理問題為：潛在危險性損傷／子宮收縮、陰道出血、早期破水，焦慮／對早產徵兆及安胎結果不確定，剖腹產後護理問題為：潛在危險性感染／術後傷口、導管留置、產後復舊，焦慮／對早產兒存活率及預後結果不確定。筆者除提供身體方面的照護外，更運用傾聽、同理心的技巧，化解個案對護理人員的冷漠與不信任，建立良好的治療性人際關係，進而深入協助個案調適安胎與產下極低體重早產兒所帶來的心理衝擊。

關鍵字

安胎 ； 早產

並列摘要

Tocolysis was attempted in a pregnant woman in premature labor at 26 weeks of gestation. Nursing care over approximately 3 weeks involved helping the patient to face the physical and psychological challenges posed by her condition. The author used Gordon's 11-items functional health patterns to evaluate the patient. Data was collected by physical assessment, observation, and face-to-face interviews. During tocolysis, two major nursing problems were identified. There was risk of injury secondary to uterine contractions and vaginal bleeding, and the patient was anxious because of the uncertainty of the situation. When tocolysis failed, a cesarean section was performed, delivering an 850-gram premature infant. Postoperatively, the two major nursing problems were management of the surgical wound and catheter to minimize the risk of infection and helping the mother deal with anxiety about her premature baby's survival and health. Apart from physical care, the nurse also used listening and empathy skills to improve her relationship with the mother, which then allowed the nurse to help reduce the mother's physical and psychological distress.

並列關鍵字

tocolysis ； preterm labor