一位第二孕期終止妊娠婦女術後之護理經驗

The Nursing Experience of a Woman Who Received Cesarean Section on Termination of Second Trimester Pregnancy

本文旨在描述一位第二孕期因胎兒臍疝氣接受終止妊娠婦女術後之護理經驗。護理期間為2012年9月19日至24日，藉由會談、觀察、身體評估及查閱病歷方式收集整體性資料，確立其主要之護理問題為急性疼痛、潛在危險性感染及哀傷。筆者藉由個別性護理及以家庭為中心之照護方式，主動提供藥物及非藥物之止痛措施以緩解個案剖腹產後之急性疼痛；並提供傷口照護措施有效預防術後傷口感染；透過主動關懷、傾聽及接納方式，並提供獨立空間和時間以鼓勵個案與家屬能表達哀傷感受及宣洩情緒，以及提供個案與家屬遺傳專業諮詢，以釐清其錯誤觀念，緩解個案因產下異常胎兒所引發之愧疚及罪惡感，協助順利度過哀傷階段。冀望此護理經驗能提供護理同仁照顧此類個案之參考。

This article describes a nursing experience of caring for a woman post-Cesarean section for termination of the second trimester of pregnancy because of fetus omphalocele. The care period was from September 9 to 24, 2012. Data were collected through patient observation, interviews, physical examinations, and medical record review. The major nursing care problems were acute pain, potential risk for infection, and the possibility of bereavement. The author adopted an individualized family-centered care model, proactively offered pharmacological measures and interventional procedures for acute pain relief secondary to Cesarean section, and provided care to prevent infection of the surgical incision. The author demonstrated active caring and attentive listening with empathy, and the patient and the patient's family were able to sufficiently express their grieving emotions. Moreover, the patient and the patient's family received genetic consultation to clarify their misconceptions and relieve all sense of guilt about the abnormal fetus. The patient and family went through their grieving period smoothly. The author expects this nursing experience to serve as a reference for other nurses taking care of patients in a similar situation.