一位990公克早產兒之加護護理經驗

Intensive Nursing Experience in Looking Agter a 990-gram Premature Infant

本文是照護一位二十七週又六天出生體重990公克之雙胞胎老二，有呼吸窘迫症候群、中樞性呼吸暫停、合併早產兒視網膜病變的極低出生體重早產兒，住新生兒加護病房的護理經驗。筆者自91年9月3日至91年11月6日擔任主護護士期間，透過直接照護、觀察、非結構性會談等方式收集資料，對個案做身體、自我調節行為及家庭方面的評估，分析歸納個案住加護病房期間主要的護理問題有：(1)低效性呼吸型態。(2)潛在危險性皮膚完整性受損。(3)混亂性嬰兒行為。(4)潛在危險性父母－嬰兒依附關係改變。筆者運用發展支持性照護原則的護理過程，幫助個案組織統整化行為，並且不限制父母的探訪時間，早日讓父母與個案進行袋鼠式照顧，促成早產兒親子依附關係的建立。藉由此次護理經驗肯定了發展支持性照護對早產兒照顧的重要性。

This article describes a nursing experience in the newborn intensive care unit while caring for an extremely low-birth-body-weight premature infant twin B, whose gestation period was 27+6 weeks, 990 gram birth body weight, complicated with respiratory distress syndrome, central apnea, and retinopathy of prematurity. The author served as the primary nurse from September 3, 2002 to November 6, 2002. We employed the information collected through direct nursing care, clinical observation, along with comprehensive interview, adding to the assessment by the patient's physical examination, the evaluation of the behavior ego, and family aspect. Nursing problems addressed in this case during the intensive care unit hospitalization period were as follows: (1)Ineffective breathing pattern; (2)Impaired risk for skin integrity; (3)Confusion of infant behavior; (4)Altered risk for patient-infant attachment. The editor helped the case to achieve a organizational behavior by using the method of developmental care. In addition, no restriction was placed on the parents' visiting and we encouraged the relationship between the premature baby and the parents by processing of kangaroo care. This nursing experience has emphasized the importance of developmental care to the premature infant.