Ngā Tikanga Tiaki Kaiwhakawhanau i ngā Take Lupus
Pendahuluan
Ko te Lupus, inā koa ko te systemic lupus erythematosus (SLE), he mate pūnaha ārai mate mau tonu ka pā ki ngā whekau maha, tae atu ki te kiri, ngā hononga, ngā whatukuhu, te toto, ngā pukahukahu, me te pūnaha io. Mō ngā wāhine o te tau whānau, he āwangawanga nui te lupus nā te mea ka pā ki te momonatanga, te hāputanga, me te haumaru o te whaea me te tamaiti i roto i te pēpi. I roto i te horopaki o te whānautanga, me whai ngā mate lupus. ngā tikanga whakatipu tamariki He manaaki whānui, pumau, me te mahi tahi puta noa i ngā umanga. He mahi tā ngā kaiwhakawhanau ki te kimi wawe i ngā mōrearea, te aroturuki i te whaea me te pēpi, te ako hauora, me te whakarite kia tukuna wawe mai ngā tamariki ina puta he āhuatanga ohorere.
Ngā Ariā Taketake o te Lupus i te Wā Hapūtanga
Te haputanga o te whaea E kiia ana te haputanga me te lupus he mate morearea nui. Ka taea e te lupus te pumau (whakamamae) te kaha rānei (whakaputa). Ko te haputanga i te wā e kaha ana te lupus e hono ana ki te pikinga o te mōrearea o ngā raruraru: te preeclampsia, te whānautanga wawe, te aukati tipu intrauterine (IUGR), ngā raruraru tākihi, te thrombosis, te anemia, te thrombocytopenia, tae noa ki te matenga o te tamaiti. Hei tāpiri, ko te noho mai o ētahi paturopi, pērā i te anti-Ro/SSA me te anti-La/SSB, ka whakanui ake i te mōrearea o te neonatal lupus me te aukati ngakau whānau i roto i te tamaiti. Nō reira, ko te kaupapa matua ko te whakamahere i te haputanga ina pumau te lupus mō te iti rawa o te 6 marama me te aroturuki tata puta noa i te haputanga me muri i te whānautanga.
Ngā Whāinga o te Manaaki Kaiwhakawhanau i ngā Take Lupus
Ko ngā tikanga tiaki whānau mō ngā whaea whai lupus e whai ana ki:
1. Kia mau tonu te pumau te mate me te ārai i te hokinga whakamuri
2. Te kite wawe i ngā raruraru a te whaea pērā i te preeclampsia, ngā mate tākihi, me te thromboembolism.
3. Te Aroturuki te tipu me te whanaketanga te pēpi me te oranga tonu o te pēpi i roto i te kōpū.
4. Whakarato mātauranga me te tautoko hinengaro kia taea ai e ngā whaea te tiaki i a rātou anō.
5. Kia whakarite kia whakaritea ngā tukunga me te mahi tahi me ngā tohunga mō te whānautanga, te rongoā ā-roto/te rongoā rumatiki, te rongoā nephrology, me te rongoā tamariki.
Aromatawai i te Manaaki Kaiwhakawhanau
Me nui ake ngā taipitopito mō te aromatawai mō te lupus i tērā mō te hāputanga noa. Me kohikohi e te kaiwhakawhanau ngā raraunga e whai ake nei:
– Hītori o te mate Lupus: i te wā i tautuhia ai, ngā whekau e pā ana (ina koa ko ngā whatukuhu), te auau o te horapa, me te hītori o te whakaurunga ki te hōhipera.
– Hītori rongoā: te whakamahinga o ngā corticosteroids, hydroxychloroquine, azathioprine, ngā rongoā whakaheke toto, ngā rongoā ārai toto rānei. He mea nui kia aromatawaihia te tutuki o ngā whakaritenga me ngā pānga taha.
– Hītori whānau: te whakatahe auau, te whānautanga wawe, ngā pēpi iti te taumaha i te whānautanga, te matenga o te kukune, me te preeclampsia o mua.
– Ngā tohu o te hokinga mai o te mate: mamae nui o ngā hononga, te ponana o te mate pāwera, te mate pukupuku o te waha, te kirika kāore e kitea te mate, te pupuhi, te heke o te mimi, te poto o te manawa, me te ngenge nui.
– Ngā tohu mōrearea o te hapūtanga: te ānini nui, te tirohanga pōuri, te mamae o te puku, te pupuhi ohorere, te toto, te ngoikore rānei o te nekehanga o te kukune.
Ka arotahi te whakamātautau tinana ki te toto totoka, te pupuhi, ngā tohu o te anemia, te whakamātautau kiri, me te āhua o te manawa. Ko ngā whakamātautau āwhina e tika ana ko te tātaritanga mimi mō te pūmua, te mahi a te whatukuhu, te tatau toto katoa, me te aromatawai i te tipu o te kukune mā te ultrasound (i runga i te mana whakahaere a te ratonga me te ara tuku).
Te Tātaritanga me te Tāutu Raru
I muri i te aromatawai, ka whakatakoto te kaiwhakawhanau i tētahi tātaritanga whānau me ngā raruraru pea, hei tauira:
– He haputanga mōrearea nui me te lupus.
– Te mōrearea o te preeclampsia/te toto toto tiketike i te wā hapūtanga.
– Te mōrearea o te IUGR me te whānautanga wawe.
– Te mōrearea o te thromboembolism, inā koa mēnā he mate antiphospholipid syndrome.
– Ngā matea mātauranga e pā ana ki te whai i ngā whakaritenga whakaora, ngā tauira okiokinga, te kai totika, me ngā tohu mōrearea.
I roto i ngā mahi, me wehewehe anō hoki e ngā kaiwhakawhanau ngā tohu o te mate lupus i ngā raruraru whānau pēnei i te preeclampsia, nā te mea he rite tonu ngā mea e rua (hei tauira, te proteinuria me te toto toto tiketike). I roto i ēnei āhuatanga, he mea nui te tuku wawe me te mahi tahi ki te tiaki.
Te Whakamahere Manaaki
Kei runga i te āhua o te whaea, te tau o te haputanga, me te pumau o te mate lupus te mahere. Ko ngā mea matua ko:
1. He maha ake ngā haerenga tirotiro ANC i ngā hāputanga noa, hei aroturuki i te toto toto, te pupuhi, me te āhua whānui.
2. Te aroturuki auau i te kukune, tae atu ki te teitei o te turanga o te kōpū, te nekehanga o te kukune, me te tuku i ngā tirotiro ultrasound hei aromatawai i te tipu me te wai o te amniotic.
3. Mahere tuku kua whakaritea mēnā ka kitea ngā tohu o te pikinga o te toto, te pikinga o te pūmua mimi, te toto toto tiketike, te ngoikore o te mahi a te tākihi, te kore rānei o ngā hua aroturukitanga o te kukune.
4. Te whakaora tahi, kia mōhio ai kei te whiwhi te whaea i te maimoatanga haumaru mō te hapūtanga, ā, kia kaua e mutu te rongoā i te wā kotahi.
5. Te mātauranga me te tohutohu hōhonu, tae atu ki te whakamahere whānau i tētahi whare tuku e whai mana ana ki te whakahaere i ngā mōrearea nui.
Te Whakatinanatanga (Ngā Mahi) o te Manaaki Kaiwhakawhanau
1. Te Tiaki i mua i te Whānautanga
Ko ngā tikanga i mua i te whānautanga mō ngā whaea whai lupus ko:
– Te aroturuki i ngā tohu ora me ngā tohu haumanu i ia haerenga mai: te toto toto tiketike, te taumaha nui, te pupuhi, ngā amuamu mō te mamae o ngā hononga/te mākūkū/te kirika.
– Te tirotiro mō ngā tohu o te preeclampsia: te ānini, te tirohanga pōuri, te mamae o te uma, te pūmua i roto i te mimi (mēnā e wātea ana), me ngā uruparenga.
– Te mātauranga hauora: te hiranga o te okiokinga nui, te karo i te ahotea nui, te pupuri i te makuku, me te whakaiti i te nui o te pānga o te rā mēnā ka puta he ponana.
– Tautoko kai: he kai taurite kei roto i te pūmua kounga teitei, te rino, te folate, te konupūmā, me te whakaiti i te tote mēnā he toto toto tiketike/pupuhi.
– Te piripono ki te rongoā: E whakanui ana ngā kaiwhakawhanau he maha ngā wā ka tūtohutia kia whakamahia tonutia ētahi rongoā, pērā i te hydroxychloroquine, e ai ki ngā tohutohu a te tākuta, nā te mea ka āwhina i te pehi i ngā mura o te mate me te whakapai ake i ngā putanga o te hāputanga.
– Te tohutohu mō ngā tohu mōrearea: me mārama ngā whaea me ngā whānau āhea te wā tika hei haere tonu ki te whare hauora.
2. Te Tiaki i roto i te Whānautanga (Whānautanga)
Ko te mea pai, ko te whānautanga o ngā whaea whai lupus me puta i roto i tētahi whare hauora e āhei ana ki te whakahaere i ngā raruraru. Ko ngā tikanga ā-roto i te whānautanga ko:
– Te aro turuki tata i te toto totoka, te totohu, me ngā tohu o te mamae.
– Te whakahaere i te mamae me te ngenge me te huarahi tautoko, nā te mea he ngāwari te ngenge o ngā whaea whai lupus.
– Matapaetia ngā raruraru pēnei i te preeclampsia, te pakaru o te whenua, te toto rānei i muri i te whānautanga mēnā he iti ngā pereti toto.
– Te mahi tahi i roto i ngā tikanga hauora mēnā e hiahiatia ana te whakauru, te pokanga tākuta, te hoatu rānei i ētahi rongoā.
Ka whakarite te kaiwhakawhanau kia tuhia te tuhinga o te partograph, ka aromatawai i te ahunga whakamua o te whānautanga, ā, ka tukuna tonutia atu mēnā he rerekētanga.
3. Te Tiaki i muri i te Whānautanga
He wā e tere haere ana te horapa o te lupus i te wā i muri i te whānautanga. Ngā tikanga whakatipu tamariki i muri i te whānautanga kei roto i ēnei:
– Te aro turuki i ngā tohu o te mate me te toto, tae atu ki te aromatawai i te involvement o te kōpū me ngā lochia.
– Aroturukihia te toto toto me ngā tohumate e pā mai ana, inā koa i ngā wiki tōmua.
– Tautoko whāngai ū: Ka taea e te nuinga o ngā wāhine whai lupus te whāngai ū, engari me whakarerekē pea ngā rongoā. Ka taea e ngā kaiwhakawhanau te āwhina i ngā whaea ki te kōrero mō te haumaru o ngā rongoā me ā rātou tākuta i te wā e whāngai ana.
– Te whakahaere i te ngenge: whakatenatenahia te tautoko a te whānau kia nui ai te okiokinga o te whaea.
– Te tohutohu whakamahere whānau: te whiriwhiri i tētahi tikanga haumaru i runga i tō āhua (hei tauira, te whakaaro ki te mōrearea o te thrombosis me ētahi tikanga homoni me ngā āhuatanga paturopi antiphospholipid). Me whiriwhiri te tikanga ārai whānau mā te tohutohu me te mahi tahi me te tākuta.
Te tiaki i ngā pēpi hou o ngā whaea me te Lupus
Me aroturuki ngā pēpi mō te whānautanga wawe, te taumaha iti i te whānautanga (LBW), me ngā tohu o te neonatal lupus (he ponana, he mate toto, he raruraru ngākau rānei). Mena e mōhiotia ana kei te whaea he paturopi anti-Ro/SSA, anti-La/SSB rānei, he mea nui te aroturuki i te ngākau o te kukune i te wā e hapu ana me te aromatawai i muri i te whānautanga. He mahi tā ngā kaiwhakawhanau ki te kite wawe i ngā tohu mōrearea i roto i ngā pēpi hou, me te whakarite kia tukuna atu ki te tākuta tamariki mēnā e tika ana.
Aromatawai me te Tuhituhi
Ka whakahaerehia ngā aromatawai i ia wā, i ia wā, hei whakatau mēnā kei te pumau tonu te lupus, mēnā he raruraru whānau, me te āhua o te kukune/pēpi. Me whakaoti ngā tuhinga tiaki: ngā hua aromatawai, ngā mahere, ngā mahi, te mātauranga, me te urupare a te whaea. Mā te tuhinga pai ka whakapakari i te haere tonu o te tiaki i waenga i ngā kaiwhakawhanau, ngā tākuta, me ngā wāhi tuku.
Whakamutunga
Ko ngā tikanga tiaki a te kaiwhakawhanau mō te lupus me tino mataara, me te whai huarahi whānui hoki. Ko te mahi a te kaiwhakawhanau ko te aromatawai hōhonu, te aroturuki tata, te ako tonu, te tautoko hinengaro, me te mahi tahi a ngā tohunga ngaio. Mā te whakamahere tika mō te haputanga, te aroturuki auau, me te tuku i te wā tika, ka taea e te nuinga o ngā wāhine whai lupus te whānau haumaru me te whānau mō te whaea me te pēpi.
Ki te hiahia koe, ka taea e au te whakarerekē i tēnei tuhinga hei whakatakotoranga pepa (papamuri–whakatakoto rapanga–kōrero–whakamutunga) ka taea rānei te tāpiri i tētahi rārangi pukapuka e ai ki te momo APA/Vancouver.
