- 期刊
照顧一位先天性肺部呼吸道畸形新生兒之護理經驗
Nursing Experience of Caring for a Newborn With Congenital Pulmonary Airway Malformation
摘要
本文為照顧一位先天性肺部呼吸道畸形新生兒之護理經驗，護理期間自2019年8月12日至2019年8月30日。個案出生後便因呼吸窘迫，面臨生存的危機入住加護病房，使案父母在擔憂疾病變化的同時，還需面對新生兒分離焦慮，對案父母造成巨大的衝擊。首次擔任此案例之主護護理師，期盼能提供適切及完整的護理，成為探討此個案照護的動機，經由實際臨床照護與觀察，運用系統性評估、與案父母溝通會談、蒐集主客觀資料等，確立健康問題：低效性呼吸型態、疼痛、照顧者角色緊張。經由個別性的護理措施：（一）提供胸腔物理治療，利用姿勢擺位減少低血氧的發生、促進儘早脫離呼吸器；（二）對於個案因術後產生的疼痛有所警覺性，採集中護理方式，同時降低環境噪音、光線等刺激；（三）協助案父母學習參與個案之日常照護，增進親子依附關係，以降低案父母內心的焦慮。建議醫護單位成立與先天性肺部呼吸道畸形新生兒相關照護之資料庫，以提升護理工作效率及品質，亦期盼藉由此護理經驗提供護理同仁照護類似個案之參考。
並列摘要
Herein, we describe the nursing experience of caring for a newborn with congenital pulmonary airway malformation. The care period was August 12 to August 30, 2019. The patient experienced respiratory distress and was admitted to the intensive care unit. As a result, his parents experienced separation anxiety and stress caused by worry regarding his condition. A primary care nurse provided appropriate comprehensive care, including systematic evaluation, communication with the parents, and collection of subjective and objective data. The following problems were identified: inefficient breathing patterns, pain, and caregiver role strain. The following nursing measures are recommended: (1) thoracic physiotherapy with the patient in the prone position for preventing the hypoxia and promoting ventilator weaning; (2) monitoring of the pain experienced by the patient after the operation through nursing methods while reducing environmental noise, light, and other stimuli; and (3) assisting the parents of newborns in providing daily care to the patient, enhancing parent-child attachment, and reducing the anxiety of the parents. Moreover, medical and nursing units should establish a database of nursing care measures related to neonates with congenital pulmonary and respiratory malformations to be used as a reference by nursing colleagues, thereby improving the efficiency and quality of nursing work.