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
In many hospitals, it is part of the daily routine to measure and record
the height of the fundus (Fig. 116) above the symphysis, in addition to
noting the character, amount and odor of the lochia, in order to judge
if involution is progressing normally. A uterus that does not remain
firm and does not steadily shrink in size and descend into the pelvis is
not involuting properly, and the usual remedy is more rest and a longer
stay in bed, with an icecap over the fundus.
=Sitting Up.= Except when there are perineal stitches or the temperature
has been elevated at some time following delivery, the patient is
ordinarily allowed to sit up in bed about the sixth or eighth day. If
the lochia is normal, the uterus firm and in the proper position in the
abdomen and her general condition satisfactory, she is allowed to sit up
in a chair for a little while about the ninth or tenth day. Some
patients are able to sit up for an hour the first time without being
tired, but it is often better for them to sit up for a few moments
morning and afternoon on the first day, than for a longer time at one
stretch. The patient is usually allowed to sit up an hour longer on each
successive day and to walk a few steps on the third or fourth day after
getting up.
A patient with stitches does not usually sit up in bed until the ninth
or tenth day, when the stitches are removed, sitting up in a chair for
an hour, two or three days later. If she has had fever, the time at
which she may sit up will of necessity depend upon her condition.
The return to normal life must be very gradual and this also must be
regulated by the patient’s general condition and her recuperative
powers. A pinkish or red discharge or backache should be taken as
warnings against standing or walking or working. The possible
consequences of ignoring these warnings and being up and about too soon,
may be displacement, even prolapse of the uterus; hemorrhage, from
dislodgment of clots in the uterine vessels; metritis or endometritis.
It is not a good plan, as a rule, for the patient to go up and down
stairs until the baby is about four weeks old, nor wholly to resume her
normal activities within six or eight weeks after delivery.
In addition to this sustained, general care, it is a customary
preventive measure for the doctor to make a thorough pelvic examination
from four to six weeks after delivery. A slight abnormality, if detected
at this time may usually be corrected with little difficulty, but if
allowed to persist may result in chronic invalidism or necessitate an
operation. If the uterus is not properly involuted, for example, or the
perineum is found to be flabby, more rest in bed is indicated; while a
uterine displacement, which seems to be present in about a third of all
cases, usually may be corrected by the adjustment of a pessary.
Public-domain text, read in full here on John Shaqi.
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