一位罹患壞死性腸炎低體重早產兒的護理經驗

Nursing Experience of a Low Birth Weight Premature Infant with Necrotizing Enterocolitis

本文旨在呈現一位罹患壞死性腸炎低體重早產兒面臨生理功能不穩定的護理經驗。個案係為懷孕29週出生體重為782公克之早產兒，個案出生後入住於新生兒加護病房，筆者護理期間自90年10月23日至90年11月16日照護個案，運用羅氏適應模式進行身體評估、觀察其行為方式確立個案健康問題包括有：一、氣體交換障礙。二、混亂性嬰兒行為。三、睡眠型態紊亂。四、皮膚完整性受損。筆者提供適當的護理計劃介入，在生理性照護方面，協助監測個案氧合狀態及維持通氣功能的穩定；而感覺系統方面，則減少環境中過多的感覺刺激的措施，如音量、觸覺及光線的控制等，以維持及提供個案有良好的睡眠型態；照護迴腸造口及周圍皮膚的護理，透過完整性的照護措施，使個案的健康問題逐一獲得改善。藉由此個案報告的護理經驗，筆者深覺護理人員在早產兒的照護上扮演著極重要的角色，期望提供給予臨床護理人員在照顧早產兒的參考，以提升其專業照護品質及完整且持續性的照護。

This article described the nursing experience for a low birth weight premature infant with narcotizing enterocolitis. The case was assessed by Roy’s Nursing model and observed from 2001/10/23 to 2001/11/16. The case presented four health problems, including gas exchange impaired, infant behavior disorganized, sleep pattern disturbance, and skin integrity impaired. The physical problem were alleviated after an appropriate nursing plan, which provided monitor oxygenation to keep ventilation function stable in physiology, reduced sensory stimulation in the environment, such as sound, touch, light control to maintain good sleep pattern, and provided care for the skin of peri-colontomic areas. The nursing experience from this case report can help nurses to take care of similar cases and improve quality of nursing care for premature infant.