A reference hand-book for nursesBeck, Amanda K. (Amanda Kathryn)
Science
A reference hand-book for nurses
Beck, Amanda K. (Amanda Kathryn)
Nursing
=Third Stage.=—The patient has a rest for some minutes. Then the
contractions of the uterus continue until the membranes and placenta
are expelled. The pains begin again; the uterus is smaller, firm,
yet will recoil; it is rounded, and the fundus lies even with the
umbilicus. If the fundus is above the umbilicus something is wrong.
Painful contractions of the uterus follow and cause a squeezing off of
the placenta. There is a flow of blood, the placenta follows, passes
out of the vagina, dragging the membranes after it. The fundus sinks,
and the uterus, hard, contracted and firm, lies in the pelvis. In some
cases it becomes soft, rises up and then relaxes. If it becomes too
soft, the relaxation which follows may induce hemorrhage. The uterus
should be carefully massaged until it hardens.
=Period of Labor.=—Fourteen hours is a normal range. First stage
usually lasts about twelve hours; second stage about one hour, and the
third stage from fifteen to thirty minutes.
=Complications of Labor.=—Labor may be brought on by extreme mental
anxiety. The child may be born without any actual pain. It may be
expelled while the patient has an evacuation of the bowels, especially
if the bowel movement has been induced by enemata or a purgative.
Children may be born without the usual progression of labor, yet with
all normal conditions present. In cases where the mother dies during
labor the uterus continues to contract until the child is born about
fifteen minutes later. The child in such cases is sometimes saved by a
Cesarean section.
CARE OF THE OBSTETRIC PATIENT.
=Diet.=—Diet should be regulated and consist of light, nutritious and
predigested foods. Milk should be prepared in various ways palatable to
the patient. Wine and fruits and vegetables in season may be included.
For malnutritious patients, malt and beef extracts may be added.
Starches prepared in fat, and rich pastries should be avoided.
=Elimination.=—The bowels must move regularly, and laxatives may be
given if necessary. Alkalies should be given before bedtime, and
effervescent powders in the morning. Enemata should not be resorted to
unless absolutely necessary, as the sudden expulsion of the contents
may produce abortion. The kidneys may be regulated by giving simple
diuretics; plenty of pure water is the best. The condition of the
kidneys is a most important factor in pregnancy. The urine should be
clear and of sufficient quantity. Meats should be eaten but sparingly,
as they over-produce albumin.
=Baths.=—Daily bathing in tepid water is very essential to encourage
the elimination through the skin and to promote cleanliness. A cold
sponge is stimulating and very agreeable to some patients.
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