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題名:運用安寧照護於早產28週合併嚴重持續性肺高壓個案之護理經驗
書刊名:長庚護理
作者:陳貽雯許菊玲戴仲宜
作者(外文):Chen, Yi-wenHsu, Chu-lingTai, Chung Yi
出版日期:2015
卷期:26:2=90
頁次:頁214-222
主題關鍵詞:早產兒安寧照護持續性肺動脈高壓Premature infantsPalliative carePersistent pulmonary hypertension
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:10
  • 點閱點閱:11
本篇個案報告運用安寧照護於合併有嚴重持續性肺動脈高壓早產兒之護理經驗,筆者於2011年8月21日至9月11日的護理期間,運用Gordon十一項健康功能型態為評估架構,確立個案健康問題有:一、氣體交換障礙;二、預期性哀傷;三、高危險性皮膚完整性受損等護理問題。予協助使用高頻振盪呼吸器及一氧化氮治療,並在病情持續惡化時提供安寧措施;在案父母面對預期性哀傷時,主動詢問並鼓勵說出心中感受和問題;提供水枕、人工皮、乳液或嬰兒油使用及加強翻身擺位等,預防皮膚完整性受損。個案於生命末期時未受到過多痛苦,在個案父母簽署放棄急救同意書後,個案於9/11走到生命終點。筆者期望以此護理經驗,作為日後護理同仁運用安寧照護於重症早產兒之參考。
The objective of this article is to describe the nursing experiences accumulated from providing palliative care to a premature infant with severe persistent pulmonary hypertension. Adopting Gordon 11 functional health patterns as the mainframe of this assessment from 21/08/2011 to 11/09/2011, three main nursing diagnoses had been identified as follows: (1) Impaired gas exchange (2) Anticipatory grieving (3) Risk of impaired skin integrity. The nursing progress was consequently divided into three parts (1) the nurse assisted with using high-frequency oscillatory ventilation and nitric oxide therapy. Palliative care was applied to enhance the case's comfort during the progression of disease. (2) To face the anticipatory grieving, initiative for consultation was taken to encourage parents to express feelings and problems at the same time the frequency of interviews increased as well as relevant medical resources provided. (3) Approaches such as providing water pillow, baby lotion or oil and increasing the frequency of positioning were all used to prevent the infant's skin integrity damage. After this infant's parents signed the Consent of No Resuscitate, this patient went to the end of life on 11/09/2011 without much suffering. By documenting this nursing experience, the author wishes to provide valuable knowledge associated with palliative care that will be considered by colleagues in nursing critical preterm infant.
期刊論文
1.Afsar, F. S.(2009)。Skin care for preterm and term neonates。Clinical and Experimental Dermatology,34(8),855-858。  new window
2.Branchett, K.、Stretton, J.(2012)。Neonatal palliative and end of life care: What parents want from professionals。Journal of Neonatal Nursing,18,40-44。  new window
3.Kain, V. J.(2013)。An exploration of the grief experiences of neonatal nurses: A focus group study。Journal of Neonatal Nursing,19,80-88。  new window
4.Maguire, C. M.、Walther, F. J.、Sprij, A. J.、Le Cessie, S.、Wit, J. M.、Veen, S.(2009)。Effects of individualized developmental care in a randomized trial of preterm infants <32 weeks。Pediatrics,124(4),1021-1030。  new window
5.Miriam, D. F.(2011)。Wound care in the neonatal intensive care unit。Neonatal Network,30(5),291-303。  new window
6.Morgan, D.(2009)。Caring for dying children: assessing the needs of the pediatric palliative care nurse。Pediatric Nursing,35(2),86-90。  new window
7.Niccolls, C.(2012)。Persistent pulmonary hypertension of the newborn。Journal of Neonatal Nursing,18(1),63-71。  new window
8.陳雅惠、陳月枝、駱麗華、林東燦、王建得(20081200)。兒科急重症病房護理人員照護臨終兒童之困境。長庚護理,19(4)=64,450-460。new window  延伸查詢new window
9.劉秀美(20071000)。喪失早產兒的父母之悲傷及照護。護理雜誌,54(5),88-92。new window  延伸查詢new window
10.Docherty, S. L.、Miles, M. S.、Brandon, D.(2007)。Searching for “The dying point:” providers' experiences with palliative care in pediatric acute care。Pediatric Nursing,33(4),335-341。  new window
11.張麗娟、黃美智(20090600)。先天性畸型新生兒不施行心肺復甦術的倫理抉擇。護理雜誌,56(3),99-104。new window  延伸查詢new window
學位論文
1.張育菁(2009)。探討某醫學中心新生兒加護病房之臨終照護(碩士論文)。臺北醫學大學。  延伸查詢new window
其他
1.早產兒基金會(2012)。認識早產,http://www.pbf.org.tw/html/c01.asp。  延伸查詢new window
圖書論文
1.Askin, D. F.(2010)。Respiratory distress。Core Curriculum For Neonatal Intensive Care Nursing。St. Louis, Missouri:Saunders Elsevier。  new window
2.Carlo, W. A.(2011)。Overview of Mortality and Morbidity。Nelson Textbook Of Pediatrics。Philadelphia, PA:Elsevier。  new window
3.Shviraga, B.、Landry, N.(2010)。Uncomplicated antepartum, intrapartum, and postpartum care。Core Curriculum For Neonatal Intensive Care Nursing。St. Louis, Missouri:Saunders Elsevier。  new window
 
 
 
 
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