一位CHARGE聯合畸形兒之護理經驗

本文探討一位CHARGE聯合畸形新生兒於新生兒加護病房中之護理過程，護理期間由2006年五月十四日至2006年八月十日，運用Gordon十一項功能健康型態為評估工具，並透過觀察與非結構性訪談進行資料收集與分析，探討個案及父母於住院期間所面臨的健康問題與需求，結果發現主要護理問題，包含呼吸道清除功能失效、潛在危險性感染、潛在危險性肺吸入、潛在危險性父母－嬰兒依附關係改變。筆者於個案住院期間依其個別需求，提供呼吸照護與預防性感染措施，同時運用發展支持性照護技巧，以圍巢提洪適當支托，減少環境刺激、促進氧合，滿足個案住院期間之生理需求。父母方面則透過不斷的溝通、鼓勵與情緒支持，增加父母對個案病情癒後的瞭解，協助親子依附關係之發展。
This case report explores the care of an infant with CHARGE association, a constellation of congenital malformations, in a neonatal intensive care unit (NICU). Using a non-structured interview and observation, we collected data regarding the infant's nursing care problems and parental needs between May 14th and August 10th 2006 and evaluated the data using Gordon 11 functional health assessment Primary nursing problems were ineffective airway clearance, risk of infection, risk of aspiration, and risk of altered parent-infant attachment. The patient was provided preventive respiratory care, infection care, and supportive care to maintain case stability and reduce harmful stimulation during hospitalization. The parents were coached on how to communicate and given encouragement and mood support. By the end of the nursing period, the child's condition and parent-child relations had improved.