照護一位初產婦安胎失敗轉待產之護理經驗

The Nursing Experience of a Primipara with Preterm Labor after Tocolysis Failure

本文旨在描述一位懷孕33週又六天之初產婦，因早期宮縮住院安胎，但安胎失敗轉待產之護理經驗。護理期間自2014年3月12日至2014年3月16日。在照護期間以Gordon十一項功能性健康型態為評估工具，發現個案在安胎期間因擔心胎兒的健康，而有「焦慮」的健康問題，也因為安胎期間使用安胎藥物及絕對臥床休息而出現「舒適障礙」的健康問題；另外在待產期間個案欠缺對生產時子宮收縮疼痛的因應能力及技巧，而有「產痛」的健康問題。於護理過程中，筆者藉由良好的護病關係、陪伴及傾聽、對於胎兒的健康狀況主動提供訊息，並提供安胎之相關資訊，以減輕焦慮；提供身體的舒適，以滿足個案的基本生理需求；在待產期間提供生產支持，增加個案之生產控制感及獲得正向的生產經驗。盼藉此護理經驗能提供護理人員作為日後照顧類似產婦之參考。

This case report described the nursing process for a primipara with pregnancy of 33 weeks and 6 days being admitted to the hospital for tocolysis because of preterm uterine contractions. The caring period was from March 12, 2014 to March 16, 2014, according to the data analyzed by the assessment tool of Gordon’s 11 functional health patterns, the patient had the problem of “anxiety” about fetal health, “comfort impaired” related to tocolytic side effects and absolute bed rest, and “labor pain” related to ineffective individual coping. During the period of caring, the author provided care by establishing a trust relationship with the patient, accompanying, and listening; providing fetal health related and tocolysis information to reduce anxiety; supplying comfort to meet basic physical needs; and offering labor support to get locus of control and positive birth experience. The findings are helpful to serve a reference for other nurses caring similar pregnant women