照顧一位雙胞胎輸血症候群孕婦行胎兒內視鏡之手術全期護理 | 雙胞胎輸血症候群手術
張中峯,雙胞胎輸血症候群,胎兒內視鏡治療,手術全期護理,Twin-Twin Transfusion Syndrome,fetal endoscopy,perioperative nursing,本,月旦知識庫,整合十大資料庫交叉 ... 熱門: 首頁臺灣期刊 法律 公行政治 醫學 財經 社會學 教育 其他大陸期刊 核心 非核心DOI文章首頁臺灣期刊醫學長庚護理201909 (30:3期)查看詳細全文篇名照顧一位雙胞胎輸血症候群孕婦行胎兒內視鏡之手術全期護理並列篇名FetalEndoscopyPerioperativeNursingCareforaTwinPregnancyWomanwithTwin-TwinTransfusionSyndrome作者張中峯中文摘要本文描述一位38歲雙胞胎妊娠婦女,於妊娠18週時診斷為雙胞胎輸血症候群,接受胎兒內視鏡手術之護理經驗。
照護期間為2016年9月11日至9月20日,手術前、中、後期藉由訪談、觀察及傾聽等技巧,應用Orem理論及手術全期護理理論收集資料及確立問題。
照護過程中發現有:焦慮、潛在危險性手術情境的傷害、潛在性危險性感染與傷口疼痛問題。
筆者應用Orem理論於術前訪視時,提供個案相關諮詢、教育及支持性的護理措施,增加個案對胎兒內視鏡手術與手術環境的認知,以緩解焦慮情緒;術中個案因採半身麻醉失去部分自我照顧能力,給予部分代償性護理措施,以預防手術臥位、內視鏡與雷射儀器的使用,而造成潛在危險性手術情境的傷害,並提供無菌的手術環境與相關措施以避免感染問題發生;術後自我照顧能力恢復期間,提供支持與教育性護理,降低傷口疼痛。
期望藉由手術護理協助個案渡過此次手術,且能提供手術室護理人員照護此類病人之參考。
英文摘要Thisreportdescribestheperioperativenursingexperiencewitha38-year-oldwomanoftwinpregnancy.Inthe18thweekofhergestation,shewasdiagnosedwithTwin-TwinTransfusionSyndrome(TTTS)whenundergoingfetalendoscopicsurgicalcare.ThecareperiodwasfromSeptember11thto20thof2016.TheresearcherusedOrem'sself-carepatternsasatheoreticalframeworkforassessingthepatient'sneedsinphysical,mental,andsocialhealth.Duringthepreoperativeperiod,thepatient'sbiggesthealthconcernsincludedanxiety,thepotentialrisksforinjuryandriskofinfectionduringtheintraoperativephase,andthepainduringthepostoperativephase.Inthisperiod,nursingcarecoveredempatheticlistening,conceptteaching,andsupportforthepurposeofpromotingcaseawarenessofthefetalendoscopicsurgeryandsurgicalenvironmentsoastorelievethepatient'sanxiety.Moreover,duringtheoperation,half-closedanesthesiacausedthepatienttolosesomeself-careability,shewasprovidedwithsomecompensatorycaremeasurestopreventpotentiallydangeroussurgicalsituationsresultedfromtheuseofsurgicallyingposition,endoscopy,andlaserequipmentandtoprovideasepticsurgicalenvironmentaswellasrelatedmeasuresforavoidinganypossibleinfection.Inaddition,duringtheperiodwhenthepatient'scaredforherselfforpost-surgicalrecovery,shewasprovidedwithsu
照護期間為2016年9月11日至9月20日,手術前、中、後期藉由訪談、觀察及傾聽等技巧,應用Orem理論及手術全期護理理論收集資料及確立問題。
照護過程中發現有:焦慮、潛在危險性手術情境的傷害、潛在性危險性感染與傷口疼痛問題。
筆者應用Orem理論於術前訪視時,提供個案相關諮詢、教育及支持性的護理措施,增加個案對胎兒內視鏡手術與手術環境的認知,以緩解焦慮情緒;術中個案因採半身麻醉失去部分自我照顧能力,給予部分代償性護理措施,以預防手術臥位、內視鏡與雷射儀器的使用,而造成潛在危險性手術情境的傷害,並提供無菌的手術環境與相關措施以避免感染問題發生;術後自我照顧能力恢復期間,提供支持與教育性護理,降低傷口疼痛。
期望藉由手術護理協助個案渡過此次手術,且能提供手術室護理人員照護此類病人之參考。
英文摘要Thisreportdescribestheperioperativenursingexperiencewitha38-year-oldwomanoftwinpregnancy.Inthe18thweekofhergestation,shewasdiagnosedwithTwin-TwinTransfusionSyndrome(TTTS)whenundergoingfetalendoscopicsurgicalcare.ThecareperiodwasfromSeptember11thto20thof2016.TheresearcherusedOrem'sself-carepatternsasatheoreticalframeworkforassessingthepatient'sneedsinphysical,mental,andsocialhealth.Duringthepreoperativeperiod,thepatient'sbiggesthealthconcernsincludedanxiety,thepotentialrisksforinjuryandriskofinfectionduringtheintraoperativephase,andthepainduringthepostoperativephase.Inthisperiod,nursingcarecoveredempatheticlistening,conceptteaching,andsupportforthepurposeofpromotingcaseawarenessofthefetalendoscopicsurgeryandsurgicalenvironmentsoastorelievethepatient'sanxiety.Moreover,duringtheoperation,half-closedanesthesiacausedthepatienttolosesomeself-careability,shewasprovidedwithsomecompensatorycaremeasurestopreventpotentiallydangeroussurgicalsituationsresultedfromtheuseofsurgicallyingposition,endoscopy,andlaserequipmentandtoprovideasepticsurgicalenvironmentaswellasrelatedmeasuresforavoidinganypossibleinfection.Inaddition,duringtheperiodwhenthepatient'scaredforherselfforpost-surgicalrecovery,shewasprovidedwithsu