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
The danger of infecting the bladder, by carrying lochia into it upon the
catheter, is so great that some doctors choose what they regard as the
lesser of two evils, and allow the patient to be assisted to the sitting
position, if she has not a serious tear. Not infrequently the patient’s
inability to void is due to the fact that she is unaccustomed to using a
bedpan, and would have difficulty in using one under any conditions, but
is able to void while sitting up. As the danger of infection is greater
two or three days after delivery than at first, because of the beginning
decomposition of the lochia, it is very evidently important to help the
patient to establish the habit of voiding from the beginning, for if she
is catheterized once there is great likelihood that she will need to
have it continued for some days.
If the first attempts are unsuccessful, therefore, but the patient
thinks that she may be able to void later, if the efforts are repeated,
catheterization is sometimes delayed for as long as sixteen to eighteen
hours after delivery in the hope that it may be avoided altogether.
When the most persistent and painstaking efforts fail, and
catheterization is necessary, the nurse must remember the extreme
gravity of her responsibility and preserve asepsis throughout the
procedure. Although there is extreme danger of infection, it can be
prevented as a rule, and its occurrence is therefore regarded as almost
inexcusable.
In preparing for catheterization, the nurse should drape the patient as
for a vaginal examination, making sure that she is warmly covered, and
place her on a sterile douche- or bedpan. If it is done at night she
should place the light in a position at once safe and advantageous. She
should have at hand on a tray: sterile forceps; cotton pledgets; two
glass catheters (in case one should be broken or become contaminated); a
disinfecting solution such as bichlorid, 1–4,000 or lysol 1 per cent.; a
sterile receptacle in which to receive the urine; sterile towels and a
dressing basin or paper bag for the used pledgets.
The preparation of the nurse’s hands, at this point, varies in different
hospitals, but always the greatest care is taken to bring nothing
unsterile in contact with the vulva and meatus.
Public-domain text, read in full here on John Shaqi.
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