A reference hand-book for nursesBeck, Amanda K. (Amanda Kathryn)
Science
A reference hand-book for nurses
Beck, Amanda K. (Amanda Kathryn)
Nursing
=Preparatory Treatment for Patient.=—The patient should have a warm
bath, and the genitals should be scrubbed thoroughly with soap and
water. Shaving the parts is much to be desired if the patient has no
objection, then an antiseptic pad should be applied. The nurse must
be sure the bladder is empty; it is very important that a dribbling
from an over-distended bladder should not be mistaken for frequent
urinations; this is to prevent the danger of ruptured bladder from the
constant pressure of a contracting uterus; also a distended bladder
makes labor hard by interfering with the passage of the head.
=During the First Stage.=—The patient may be out of bed and encouraged
to take exercise. She should not walk about too freely before the head
is engaged, lest this induce a malpresentation or malposition. The
patient’s crying should not be prevented, and she should be told not to
press down. She may have a cup of hot water or tea, but no stimulant,
as an anesthetic may become necessary.
=During the Second Stage.=—All clothing should be removed but the
night-dress. Pin the gown up under the arm, put on perineal drawers,
and a sheet around the body, then place the patient in bed. The pain in
the back may be relieved by pressure over the sacrum, and the patient
should be encouraged to hold her breath. The nurse should now use
tact to quiet the patient, having hitherto managed, if possible, to
encourage calmness. For cramps in the limbs, the muscles may be moved
and firm pressure applied. A handkerchief bound tightly around the
affected part may relieve it. A sheet may be tied to either side of the
bed, for the patient to grasp, and a block placed at the foot of the
bed for a brace for her feet.
=Patient After Labor.=—The soiled skin should be gently and quickly
bathed with warm solution, the vulva and perineum carefully cleansed
and an antiseptic pad applied. The binder should be pinned firmly
about and below the hips, allowing freedom over the upper part of
the abdomen. If there is any anxiety that the uterus may relax after
kneading it, a tightly folded towel may be placed over the fundus, and
kept in position by the binder. A vaginal douche is never given without
orders from the physician. External douches of lysol, 1 or 2 per cent.,
are given three or four times daily until the lochia becomes scant.
The patient should be watched during the first few hours for symptoms
of hemorrhage. The room should be kept quiet and dark, and light, warm
covering be used on the bed. The patient may have a cup of hot water or
milk to induce sleep and relieve thirst.
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