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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=The Nursing Experience of Palliative Care on a 28-week-old Premature Infant with Persistent Pulmonary Hypertension |
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作者 | 陳貽雯; 許菊玲; 戴仲宜; Chen, Yi-wen; Hsu, Chu-ling; Tai, Chung Yi; |
期刊 | 長庚護理 |
出版日期 | 20150600 |
卷期 | 26:2=90 2015.06[民104.06] |
頁次 | 頁214-222 |
分類號 | 419.75 |
語文 | chi |
關鍵詞 | 早產兒; 安寧照護; 持續性肺動脈高壓; Premature infants; Palliative care; Persistent pulmonary hypertension; |
中文摘要 | 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。 |
英文摘要 | 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. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。