照顧一位胎便吸入症候群新生兒之護理經驗

A Nursing Care Experience of A Newborn with Meconium Aspiration Syndrome

本篇報告探討一位40+2週、出生體重3100公克，罹患胎便吸入症候群新生兒之護理經驗，護理期間於2017年7月31日～2017年8月6日，筆者運用羅氏適應模式，經觀察、直接護理、病歷查閱及與父母會談等方式搜集資料，評估個案生理問題及其家庭功能，確立個案有：氣體交換功能障礙、混亂型嬰兒行為、主要照顧者角色緊張等護理問題。筆者採集中護理、運用寧握護理提供適當支持性擺位，增加個案安全感並減少人為或環境中的刺激，以促進氧合及減少耗氧量，主動關懷案父、母的需要並鼓勵表達心中感受，適時提供訊息及心理支持，建立互信及良好的醫病關係，以緩解案父、母照顧者角色緊張的問題，並提供以家庭為中心的照護，引導協助案父、母學習參與照護個案，促進親子依附關係建立，使個案順利返家，獲得妥善的照顧。期盼藉此護理經驗，提供護理人員日後照護類似疾患家庭之參考。

This study described a nursing care experience of a newborn with meconium aspiration syndrome born at 40 weeks and 2 days with birth weight of 3100g from July 31 to August 6, 2017. The infant's physical problems and family function were evaluated based on the Roy's Adaptation Model and data were collected by direct observation and nursing care, medical record review and interviews with the parents. The findings were gas exchange dysfunction, disoriented baby behavior, and care-giver role strain. The centralized nursing care was used, and containment was implemented to provide supportive positioning of the infant to enhance sense of security and reduce man-made/ environmental stimulation, which facilitated gas exchange and reduced oxygen consumption. The parents were encouraged to express their feelings, and instant information and emotional support were provided to establish a good doctor-patient relationship to relieve the caregiver role strain. A family-centered service were provided for the parents to participate in the caring process and establish parental attachment after the infant returned home. It was expected that this study provided nursing care experience for nursing professionals who work with patients with meconium aspiration syndrome and their families.