一位呼吸窘迫合併顎裂之早產兒的護理經驗

本文敘述一位出生體重1,905公克，因呼吸窘迫合併顎裂之35週早產兒的護理經驗。照護期間自2020年5月11日至5月25日，藉由參與照護、整體性身體評估與家庭評估模式等方式收集相關資料，發現個案有低效性呼吸型態、低效性嬰兒哺餵型態及案父母有照護者角色緊張等主要健康問題。筆者擬定個別性護理措施，包含：維持通氣穩定促進氧合、施行口腔動作發展訓練促進吸吮、採寧握護理維持生理、行為之穩定；運用支持系統及以家庭為中心之照護提供案父母照顧個案簡易的技巧、顎裂相關的資源及居家照護等，並藉由促進親子依附關係，緩解照護者角色緊張的問題。另外透過社工尋求資源及出院後主動電訪追蹤，使個案返家後可獲得持續照護，期望藉由本次啟動跨團隊醫療及家庭為中心擬定居家照護計畫，提供日後護理同仁參考。

This article discusses the case of a newborn with a gestational age of 35 weeks and a birth weight of 1,905g, who was diagnosed with a cleft palate and respiratory tract problems at birth. From May 11th to May 25th, 2020, through direct care and utilizing comprehensive physical and family evaluation models, the author identified problems such as ineffective breathing patterns, inefficient feeding patterns, and caregiver role strain. Nursing measures were strategized, including maintaining stabilized ventilation to ensure adequate oxygenation, providing oral stimulation to promote oral feeding, and employing containment nursing skills to maintain physiological and behavioral stability. Additionally, the author encouraged parents to express and release their caregiving tensions by providing support and establishing a family-based support system. This system not only taught parents basic caregiving skills for a cleft palate but also aimed to ease caregiver stress by fostering parent-child bonding, providing individualized home care skills, and facilitating the parent-child relationship. Furthermore, post-discharge telephone follow-up and additional social resources provided by social services ensured continued care for the parents even after discharge. Through sharing this multidisciplinary team care experience, the aim is to contribute to the appropriate care of preterm infants in the future.