Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her BabyVan Blarcom, Carolyn Conant
Science
Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her Baby
Van Blarcom, Carolyn Conant
Infants -- Care; Maternity nursing; Pregnancy
Since eclampsia occurs only in connection with pregnancy, and the
convulsions usually cease if the fetus dies or is born, one line of
reasoning is that the most effective way to treat the disease is to
terminate pregnancy. Formerly this was almost always done, and is still
practised by some obstetricians. Those who do not agree with this theory
contend that the eclamptic woman is a very ill woman whose nervous
system is so irritated that the slightest stimulation or irritation
works harm. In view of this they feel that manual or instrumental
dilation of the cervix, preparatory to delivering the child through that
channel, or delivery through an incision in either the abdominal wall or
cervix, constitutes a shock that outweighs the advantages of emptying
the uterus; therefore, that as a rule, less harm is done by
noninterference, quieting the patient and increasing her eliminative
functions, than by terminating pregnancy. This line of reasoning also
takes into consideration the fact that from 15 per cent. to 20 per cent.
of the cases of eclampsia are postpartum, indicating that convulsions
may occur even after the uterus has been emptied.
The growing tendency is to adopt a middle course and treat each
individual case according to the conditions and indications which it
presents. Thus the same doctor will hastily induce labor in a case where
the blood pressure and albumen remain alarmingly high, or increase, in
spite of all efforts to reduce them, and in another case will go to the
extreme of conservatism, doing nothing but quiet the patient with
morphia or chloral, or both, and stimulate all of her excretory organs
with abundant fluids.
But the nurse’s duties, and I may say her opportunities, for she is
privileged to do much, are virtually the same no matter which course is
followed, except, of course, the preparation for delivery, if this is
performed.
The nurse is concerned with helping to reduce the intake of nitrogenous
food, or proteids; diluting the toxines retained in the body; promoting
the activity of the kidneys, bowels, liver, lungs and skin; guarding the
patient against all avoidable stimulation from without, such as noise,
light, ungentle handling and undue resistance to the patient’s
convulsive movements; and protecting her from injuring herself by biting
her tongue, falling out of bed or striking the wall or head of the bed
during convulsions.
By striving to accomplish these general results for her eclamptic
patient the nurse will aid immeasurably in saving her life.
Public-domain text, read in full here on John Shaqi.
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