How to Care for the Insane: A Manual for NursesGranger, William D.
Science
How to Care for the Insane: A Manual for Nurses
Granger, William D.
Psychiatric nursing
The action of both is practically the same. In ordinary doses they quiet
restlessness, produce muscular weakness, flushing of the face, dryness of
the tongue, wide dilatation of the pupils, and frequently cause sleep.
These effects should be noticed and reported. These medicines are mostly
given to patients who are continually restless, violent, and sleepless,
and the object is to bring quiet, repose, and sleep. Large doses may
produce coma, very heavy breathing, and great muscular weakness; the pulse
however is full and strong, but if it should fail, the physician should be
at once sent for.
_Alcohol and Stimulants._--It is the alcohol in liquors that intoxicate,
and it is that part, also, of liquor that stimulates when given as a
medicine. Whiskey, brandy, and gin are about one half alcohol. The dose is
a tablespoonful, in water, and not repeated oftener than two or three
times. Wines are about one fifth alcohol, beers and cider about one
twentieth.
Liquors containing alcohol are never to be given to patients as a
beverage, but always as a medicine, and, except in emergencies, never
without a physician's order. Do not give them in emergencies, without a
good reason for so doing, and not simply because you feel you must do
something, for in some emergencies they may do a great deal of harm, and
perhaps, a fatal injury.
Alcohol is mostly given to stimulate the action of the heart. A stimulant
is something "that arouses or excites to action." It is given (in the
doses just mentioned) in accidents, when the heart is very weak, the pulse
almost or quite imperceptible, the face pale and pinched, and the
extremities cold.
In continued sickness, with exhaustion, stimulants are sometimes left with
the attendant to give, with directions about the size of the dose and its
frequency. If it quiet the patient, strengthen the heart and pulse, it is
doing good; but if restlessness comes on, the face becomes flushed, or if
the pulse is made more rapid and feeble, it is probably doing harm, and
should be discontinued, and the physician informed.
_Dry and Moist Heat._--In applying heat, either dry or moist, to the
insane, care must always be used to protect the skin from being blistered.
This happens very easily when it is applied directly to old, feeble,
paralyzed, or paretic patients, and also to those who are too demented to
complain if they are being burned. Burns are very serious accidents among
this class of patients, and may, if they extend over a large surface,
even though not deep, heal with difficulty, and even prove fatal.
Dry heat is applied by means of rubber bags filled with hot water,
hot-sand bags, bricks, or soapstones, and by the lamp bath. Moist heat by
hot baths, fomentations, turpentine stupes, and poultices.
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