照顧慢性肺疾病合併餵食不耐早產兒之加護經驗

Intensive Care Unit Nursing Experience with a Preterm Infant with Chronic Lung Disease and Feeding Intolerance

鄭詩宜(Shih-Yi Cheng)

《榮總護理》 32卷4期 (2015/12) Pp. 374-381

https://doi.org/10.6142/VGHN.32.4.374

摘要

本文旨在描述一位慢性肺疾病併餵食不耐早產兒之家庭護理經驗。護理期間為2012年11月6日至2013年3月8日，運用系統性身體評估模式，透過觀察、團隊討論及家庭會談等方式進行個案生理、行為變化、環境和家庭評估，確立個案有氣體交換障礙、低效性嬰兒哺餵型態、混亂性嬰兒行為及潛在危險性父母等健康問題。筆者針對處於急性期的個案，擬定個別性護理計畫：維持呼吸道通暢及提供氧合；施行口腔動作發展訓練促進吸吮協調，維持體重穩定成長；利用發展性照護措施來促進個案之自我統整行為；施行寧握護理與教導袋鼠式護理以增進親子情感連結，最後協助案家租借氧氣返家行居家照護。期許藉由此護理經驗，提供護理同仁往後臨床照護此類個案之參考，進而提升專業的照護品質。

關鍵字

早產兒 ； 慢性肺 ； 低效性嬰兒哺餵型態 ； 發展性照護 ； 袋鼠護理

並列摘要

This article describes an intensive care nursing experience regarding premature infant with chronic lung disease and feeding intolerance. From November 6, 2012 to March 8, 2013, a systematic physical assessment model was used in observation, discussion groups, and family meetings to evaluate the physiological and behavioral changes in the patient, the environment, and family. Several nursing diagnoses were made, such as gas interchange disturbance, ineffi cient infant feeding patterns, confusion regarding infant behavior, and an altered risk for patient-infant attachment. Individual nursing plans were administered by the author during the acute phase: the airway was maintained and oxygenated; oral motor training was performed to promote sucking coordination and thus increase weight; care measures were used to develop the self-integration of the patient; kangaroo care and containment were provided to improve parent-child bonding; and the family was loaned an oxygen machine for home care. The results of this nursing experience can provide colleagues with a case reference for similar patients, and thus enhance the professional quality of nursing care.

並列關鍵字

premature infant ； chronic lung ； inefficient infant feeding patterns ； care measures ； kangaroo care

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