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
In preparing for feeding, attendants must see that the food is properly
made ready. If any thing is to be mixed with milk, it should be mixed so
as to be perfectly smooth, without lumps, and so it will run easily
through the tube. If some concentrated food is used, it is better to put
it in a small quantity of milk, just enough to make it liquid, that it may
be given first. Medicines ordered for feeding are not to be mixed with a
large quantity of milk, but saved, that they may be given directly from
the dispensing bottle whenever the physician desires to do so.
Every thing should be got ready for feeding before the physician arrives.
Upon a tray should be all the feeding apparatus--the food and medicine,
several spoons, and cups, and a pitcher. Near at hand should be plenty of
water, soap, and towels, and a tin basin. It is very provoking to have to
wait for many things to be brought after the patient has been got ready.
Many patients are easily fed. Some like it, but some violently and
furiously resist. Such patients should be restrained to a chair fixed to
the floor, and the more securely this is done the more easily can they be
fed, and with less fatigue and danger of their being injured.
The patient's clothing should be well protected from being soiled, by
towels about the neck, and a basin should always be held under the chin to
catch falling liquids and any thing vomited. The holding the head and
wedge is an important matter, and is some thing that belongs to the
attendant to do. The attendant stands behind the patient, and holds the
chin by the right hand, and with the left firmly grasps the wedge, which
is inserted straight into the mouth, between the back teeth, about two or
three inches. The wedge should be grasped with the palm upwards, and the
little finger and side of the hand should be pressed firmly against the
chin. If held in this way there is little danger that in violent
struggles, the wedge can be suddenly driven backward and wound and tear
the soft parts of the mouth. If the throat fills with fluid, the attendant
who holds the head should bend it far forward, that it may, if possible,
run out of the mouth.
After feeding, patients' faces should be washed. They should be watched
for some time to see that they do not vomit, or, as is often the case,
that they do not make themselves vomit.
There is no special difference in caring for a patient fed with a nasal
tube, except that the wedge is not used.
If attendants are allowed to feed, they must remember all the dangers, and
guard against them. In introducing the tube, the forefinger of the right
hand is to be introduced at the same time, and, as the tube passes over
the tongue it is to be turned downward by the finger and _gently_ pushed
into the oesophagus. If there seem to be unusual difficulty in so doing,
severe and unusual struggling, or the slightest symptom of danger, cease
the effort to feed, and report to the physician.
Public-domain text, read in full here on John Shaqi.
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