一位氣胸之早產兒的加護經驗

本文描述一位雙胞胎早產兒弟弟因氣胸插管入住新生兒加護病房的護理經驗，照護期間自2020年1月22日至2020年2月1日，透過實際臨床照護、身體評估，並與案父母會談等方式，收集相關資料進而分析，確立健康問題有：（一）低效性呼吸型態/與氣胸、呼吸窘迫有關；（二）急性疼痛／與放置氣管內管及胸腔引流管有關；（三）照顧者角色緊張／與照護早產兒知識不足有關；針對健康問題，提供個別性照護計畫，並啟動跨領域醫療團隊進行醫療措施，早產兒疼痛部分，除提供藥物性止痛方式外，合併使用非藥物性疼痛緩解，如寧握護理、音樂治療等，醫材部分選用矽凝膠敷料以固定身上管路，減少因皮膚刺激所引發的疼痛，採取以家庭為中心的整體性照護，提供案父母早產兒相關知識資訊，並鼓勵參與照護計劃，給予心理支持及讚美，有效緩解照顧者角色緊張增加照護信心外，亦使個案返家後能獲得持續性完整照護，提升整體照護品質。

This paper outlines the nursing care provided to one of twin boys diagnosed with pneumothorax upon admission to the Neonatal Intensive Care Unit (NICU) and subsequent intubation. Spanning from January 22nd to February 1st, 2020, the author employed clinical care, physical evaluations, and communication skills to gather pertinent information for analysis. The patient's health issues were identified as: (1) ineffective breathing pattern linked to pneumothorax and respiratory distress syndrome; (2) acute pain stemming from endotracheal tube placement and thoracic drainage catheter insertion; and (3) caregiver role strain experienced by the parents due to insufficient knowledge. The healthcare team devised an individualized care plan and medical interventions, overseen by an interdisciplinary team, to address the respiratory issues. Pain management involved administering medications and employing containment care and music therapy. Silicone gel dressings were utilized to secure tubes and minimize skin irritation. A family-centered approach was adopted, with the care team actively involving the parents in the care plan, providing them with relevant information and emotional support, and acknowledging their efforts. This approach aimed to alleviate parental stress and enhance their confidence as caregivers.