A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
If the vomiting persists and becomes bilious, relief is sometimes
obtained by thoroughly washing out the stomach through the stomach-tube.
The internal administration of medicines--except the purgatives already
mentioned--is of little use in vomiting of this character.
The pulse after celiotomy usually remains below 100. It often, however,
reaches 115 or 120, and sometimes higher, in patients who have a
favorable convalescence. A rapid pulse unaccompanied by unfavorable
abdominal symptoms often indicates some heart-trouble.
A pulse of over 120 accompanied by abdominal distention and vomiting
should always excite alarm.
Strychnine and digitalis, administered hypodermically, are the most
useful medicines for strengthening the heart and diminishing the
rapidity of the pulse. They should be given in large doses--1/20 of
a grain of strychnine every three or four hours, and 10 minims of
tincture of digitalis at similar intervals.
Hypodermic injections of strychnine are most useful for shock after
celiotomy. This drug may be exhibited until the physiological
action--twitching or jerking of the muscles--is observed. The writer
has administered between 1 and 2 grains during the first twenty-four
hours after celiotomy, with recovery.
The temperature after celiotomy runs no regular course. It usually
remains below 102° F. A greater elevation of temperature than this may
occur during a favorable convalescence; and; on the other hand, a fatal
termination may take place when the temperature remains lower. The
maximum temperature is usually observed about the second or third day.
The temperature often rises on account of very trivial causes. It may
go up one or two degrees if the patient should become constipated, and
will drop as soon as a free fecal movement has taken place.
[Illustration: FIG. 207.--Composite temperature-chart of a series of
150 successful cases of celiotomy: average temperatures, pulses, and
respirations for two weeks after operation.]
The comfort of the patient is much increased by sponging the arms and
legs with tepid water. The nurse should be instructed to sponge the
patient in this way whenever the temperature reaches 102° F.
The patient should maintain the recumbent posture for three weeks after
celiotomy. She may then sit up in bed for two or three days, and if
then sufficiently strong, she may leave the bed.
Too great haste in getting up may result in ventral hernia. The
incision should be strapped with adhesive plaster for five or six
weeks after operation, and the woman should wear some simple form of
abdominal binder for the following six months, or for a year if the
incision be large. She should be warned against resuming hard work,
involving lifting or other abdominal strain, for several months after
operation. She should be told of the possibility of ventral hernia,
and advised to return immediately for treatment should this condition
appear.
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