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 distended bladder may so easily occur unless the patient is carefully
observed during the puerperium that the nurse should charge herself to
watch for this complication. She should give the patient a bedpan every
four hours, note the contour of the abdomen and measure the urine during
the first week, remembering that the patient should void considerably
more than the average amount, both because of the amount of milk and
water that she is taking, and the fluid which she is eliminating from
her tissues. The importance of measuring the urine lies in the fact that
though the patient may void fairly regularly she may not empty her
bladder, and thus enough urine may accumulate to distend it.
=The temperature, pulse and respirations= are usually taken and recorded
every four hours for the first five or six days and then two or three
times daily, if normal. If the temperature is above normal at any time,
the nurse should take it every two hours until it becomes normal and
notify the doctor immediately if it goes as high as 100.4° F., or if the
pulse reaches 100.
=Care of the Perineum.= The best way of caring for the perineum, during
the first week or ten days after delivery, is a moot question, and the
nurse may find herself sorely perplexed by the widely divergent
instructions of different doctors who have excellent results, unless she
goes back of the details themselves and recognizes their purpose. She
will then see that there is entire agreement about the importance of
protecting the patient against infection, at this time, when infection
may so easily occur. And so far as the nurse is concerned, this means
cleanliness as to methods and appliances, when making perineal
dressings, and extreme precaution against conveying infection to her
patient. The minimum requisites for this are that the bedpan shall be
sterilized, by steam or boiling, at least once a day, and well scrubbed
and scalded after each time that it is used, and that the nurse shall at
least scrub her hands with soap and hot water before making each
perineal dressing, and apply only sterile pads.
After the perineum is bathed, immediately following delivery, the usual
practice is to apply a sterile pad, after which a fresh one is applied
as often as necessary at first, every four hours during the first week
and subsequently every eight hours. When the dressing is changed, and
after each voiding and defecation, the perineum is bathed with sterile
pledgets and some such antiseptic solution as bichlorid 1–2,000 or lysol
½ per cent. or 1 per cent. (Figs. 117 and 118.) The soiled pad must
always be removed from above downward and the bathing also directed
toward the rectum, each pledget being used for one stroke only. The
rectum is bathed last, a fresh sterile pad applied and the patient’s
hips and back thoroughly dried.
Public-domain text, read in full here on John Shaqi.
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