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
A milk diet is the means of reducing the nitrogen intake; or in some
cases even that small amount of proteid is deemed too much, and only
water is given until 24 to 48 hours after the convulsive seizures have
ceased. From three to five litres of these fluids should be given in the
course of twenty-four hours, in order to increase elimination by way of
both kidneys and skin, and it usually taxes the nurse’s patience and
ingenuity to give this amount, for the patient will seldom take large
quantities of fluids willingly, even when quite conscious. A surprising
amount of water may be given to the sleeping or unconscious patient by
dropping it into her mouth from the point of a teaspoon, taking care to
give it only at those moments when she is lying quite still. If the
nurse attempts to hold the restless patient’s head, or so much as places
her hand upon the chin to steady it in order to give water, the
irritation, though slight, may be enough to cause a return of the
tossing and struggling.
Lithia water and cream-of-tartar lemonade (a teaspoonful of cream of
tartar to a pint of water), are frequently given because of their
diuretic and diaphoretic action; but whatever the fluid, it must be
given persistently, with greatest gentleness and with care that the
patient does not choke nor aspirate it into her lungs and thus possibly
cause pneumonia. Food even in liquid form is not given while the patient
is unconscious, because of this danger of aspiration and subsequent
pneumonia.
The bowels are stimulated to greater activity by powerful purges, such
as croton oil, in olive oil, dropped on the back of the tongue, or salts
or castor oil given by stomach tube.
Copious _colonic irrigations_, alternating with hot packs so that one or
the other is given every six, eight or twelve hours, according to the
seriousness of the case, are frequently given and with excellent
results. A colonic irrigation may be given by means of the Murphy drip
method or through a rectal tube so contrived that a two-way flow of
fluid is possible. Water, normal saline (2 drams of salt to a quart of
water), or a weak solution of sodium bicarbonate (an ounce of soda to a
quart of water), are all used for colonic irrigations, which are given
at a temperature of 110° F., very slowly, with the receptacle for the
solution placed so low that the flow is under very slight pressure. The
patient should lie on her left side, in a comfortable position and be
warmly covered. The tube should be introduced from 12 to 18 inches, and
the stop cock arranged so that it will take from twenty to thirty
minutes for each gallon of fluid to run in and out. About two gallons
are usually used for the first irrigation, the amount being increased
until five gallons are used each time. The beneficial effects of the
colonic irrigations are two-fold, for in addition to removing the toxic
material that may be in the colon and rectum, a good deal of fluid is
absorbed through the intestinal wall.
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