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
_Hot Baths and Wet Packing._--Hot baths are sometimes prescribed for
patients. The water should be about 100 degrees F., and, if ordered,
slowly increased to 110 deg. The patient is to be left in as long as
directed, which may be but a few minutes, or half an hour, or even longer.
Sometimes a blanket is ordered thrown over the tub, the head only being
uncovered.
When the bath is being given, the pulse should be counted; if it become
weak and rapid, if the face become flushed, and the patient complains of
dizziness, or if the lips show venous congestion, the patient should be at
once removed, and, unless there is immediate recovery from these evil
effects, the physician should be informed.
In giving a wet pack, the patient is wrapped in a sheet, without any
clothing, wet either in cold or warm water, as ordered, and then rolled in
a blanket, put to bed, and left in it as long as directed.
These methods of treatment are frequently ordered by physicians for
patients who are restless, violent, and sleepless, with a view of giving
quiet and sleep. The attendant should observe and report the result.
_Application of Cold._--The attendants are frequently ordered to apply ice
to some part of the body, for the purpose of producing local cold. The ice
should be broken into small pieces and put into a bladder, or rubber bag,
partly filling it. It remains sufficiently cold until all the ice is
melted.
Another way is to put a piece of ice in a sponge and bathe the part. When
cold cloths or compresses are applied, the heat of the body soon warms
them, when they become warm applications and act as a poultice; they
should therefore be frequently changed. In applying moist dressings care
must be used not to have any leaking nor wetting of the bed or clothing.
_Hypodermic Injections._--Morphine, hyoscyamine, or hyoscine, in solution,
are frequently injected under the skin. The direction to do this, and the
quantity to be given, will, in every case, be ordered by the physician. A
fold of the skin is held between the finger and thumb, while the needle
held in the other hand is quickly pushed straight under the skin to the
depth of about half an inch. Care should be used to inject no air, and not
to inject the contents of the syringe, into a vein.
_Forcible Feeding with the Stomach-Tube._--Attendants are frequently
called upon to assist in the forcible feeding of patients, and in some
cases may themselves be directed to do it. The dangers of feeding are that
the pharynx may be filled with fluid, and the patient choke, or it may be
drawn into the lungs, that the wedge with which the mouth is held open may
be so loosely held that in the struggle of the patient the soft parts of
the mouth may be injured, and occasionally it happens that the mere
pressure of the tube causes choking.
Attendants should watch the process of feeding, and particularly the face,
for symptoms of venous congestion, and report to the physician any thing
they see that denotes danger.
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