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題名:照顧一位運用低溫治療之周產期窒息新生兒急性期護理經驗
書刊名:長庚護理
作者:黃鈺婷林淑雯
作者(外文):Huang, Yu-tingLin, Shu-wen
出版日期:2015
卷期:26:4=92
頁次:頁482-491
主題關鍵詞:周產期窒息新生兒低溫治療Perinatal hypoxiaNewbornTherapeutic hypothermia
原始連結:連回原系統網址new window
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  • 共同引用共同引用:3
  • 點閱點閱:37
本文主要是探討照顧一位新生兒因周產期窒息之急性期護理經驗,護理期間為2013 年5 月12 日至2013 年6 月10 日止,個案出生過程因周產期窒息缺氧,立即給予心肺復甦後轉至本院新生兒加護病房,入院後出現抽搐等神經異常症狀,經醫師評估建議家屬接受低溫治療來降低個案腦部受損。筆者藉由身體評估及系統性觀察等方式,確認個案主要健康問題為無效性保護能力、氣體交換障礙、潛在危險性嬰兒依附關係障礙。個案在低溫治療期間筆者除維持個案皮膚完整性、監測凝血功能、嚴格執行無菌技術和監測出血及感染症狀和徵象,還提供個案維持通氣穩定促進氧合功能,減少發生低血氧並協助個案逐漸脫離呼吸器;再藉由彈性會客促進親子依附關係建立,鼓勵案父母參與照護活動並學習照顧技能降低案父母之焦慮,共同擬定照護計畫,使個案獲得完整及持續性護理。
This article described the nursing care of a newborn with perinatal asphyxia in the acute stage. The study period was from May 12th, 2013 to June 10th, 2013. The patient received cardiopulmonary resuscitation immediately after birth at a local clinic, then transferred to our hospital NICU under the impression of perinatal asphyxia. Due to seizures and other neurological abnormalities, the patient underwent therapeutic hypothermia to attenuate the evolution of the brain insult. During therapeutic hypothermia. By using systemic assessment skills we were able to evaluate and define the patient’s physiological needs, which includes impaired gas exchange, ineffective protection, and risk for impaired parent/infant attachment. Accordingly, we aimed to maintain skin integrity, follow strict aseptic technique with patient handling, monitor, signs of bleeding and infection, provided a nursing care plan for the patient which included maintaining adequate oxygenation to stabilize the gas exchange, reducing incidence of hypoxemia, and timely weaning of the ventilator. To ease parental anxiety and improve counter attachment changes in the intensive care setting, we set up flexible visiting hours to encourage parent-child bonding. We also actively involved the parents in the care of their hospitalized infant. We also included the family in a discussion to establish comprehensive and sustainable nursing care plans.
期刊論文
1.Cooper, D. J.(2011)。Induced hypothermia for neonatal hypoxic-ischemic encephalopathy: Pathophysiology, current treatment, and nursing considerations。Neonatal Network:The Journal of Neonatal Nursing,30(1),29-35。  new window
2.Selway, L. D.(2010)。Hypoxic ischemic encephalopathy and hypothermic intervention for neonates。Advances in Neonatal Care,10(2),60-66。  new window
3.吳佳瑤、洪志秀、金繼春(20090300)。一位雙胞胎早產兒母親執行袋鼠式護理之心路歷程。長庚護理,20(1)=65,132-141。new window  延伸查詢new window
4.林永傑、林毓志、林其和(20090600)。新生兒缺氧缺血性腦病變(Hypoxic Ischemic Encephalopathy)及低溫(Hypothermia)治療。台灣新生兒科醫學會會刊,18(2),2-10。  延伸查詢new window
5.洪佳鈴、尹玓(20090600)。一位罹患自發性腸穿孔早產兒的護理經驗。長庚護理,20(2)=66,283-291。new window  延伸查詢new window
6.Hsu, C. Y.、Huang, C. H.、Tsai, M. S.、Chang, W. T.、Chen, W. J.(2011)。Current development and clinical usage of therapeutic hypothermia。Journal of Emergency and Critical Care Medicine,22(1),1-18。  new window
7.Jacobs, S. E.、Berg, M.、Hunt, R.、Tarnow-Mordi, W. O.、Inder, T. E.、Davis, P, G.(2013)。Cooling for newborns with hypoxic ischaemic encephalopathy。Cochrane Database of Systematic Reviews,2013(1),1-112。  new window
8.Nevart, C.、Nancy, M.(2011)。Therapeutic hypothermia for management of neonatal asphyxia: What nurses need to know。Care Nurse,31(3),1-12。  new window
9.Parker, L.、Kenner, C.(2012)。Neuroprotective strategies for hypoxic ischemic encephalopathy。Newborn and Infant Nursing Reviews,12(1),7-11。  new window
10.Polderman, K. H.(2009)。Mechanisms of action, physiological effects, and complications of hypothermia。Critical Care Medicine,37(7),S186-S202。  new window
11.Seetha, S.(2009)。Neonatal encephalopathy:Treatment with hypothermia。Journal of Neurotrauma,26,437-443。  new window
12.Tran, C.、Medhurst, A.、O'Connell, B.(2009)。Support needs of parents of sick and/ or preterm infants admitted to a neonatal unit。Neonatal, Paediatric and Child Health Nursing,12(2),12-17。  new window
13.Vandertak, K.(2009)。Cool competence. The nursing challenges of therapeutic hypothermia。Journal of Neonatal Nursing,15,200-203。  new window
14.吳承學、劉慧玲(20111200)。低溫治療於心跳停止復甦後病人之應用與照護。榮總護理,28(4),334-340。new window  延伸查詢new window
 
 
 
 
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