照顧一位急性淋巴性白血病新生兒接受換血治療之護理經驗

This article described the nursing experience of caring a newborn with acute lymphoblastic leukemia receiving exchange blood transfusion. During the period from 2010/12/21 to 2010/12/26, through analyzing data collected from physical examinations, family conference, and parents' statements, the health problems were identified as follows: 1. Ineffective protection that is related to leukocytosis, low platelet, and invasive procedures; 2. Disorganized infant behavior that is related to invasive procedures and environmental stimulation; 3. Caregiver role strain that is related to the fear for complications and prognosis; and 4. Risk for impaired attachment that is related to dissociation in the intensive care unit. Nursing care provided were to help increase resistance, to correct abnormal blood contents, to shorten the time of crying, to reduce the environmental noise, to decrease oxygen consumption, to provide the relevant information, to listen and accompany in time, to provide flexible meeting, and to decrease the anxiety level by supportive communication. During the caring period, the patient's vital signs were stable, caloric intake was adequate, and sleep patterns were regular with no other complications. Parents could also actively participate in daily care, and establish a good parents-infant relationship. This report would serve as a reference for nursing staff for caring similar patients and improving quality of nursing care.