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
It was formerly the practice to curette the patient suffering from
puerperal infection, and give intra-uterine douches, but it is now
pretty generally believed that neither of these procedures does any
appreciable good, but on the other hand may do harm. The objection to
curettage is on the ground that by this means the protective wall which
Nature has developed to prevent the further invasion of bacteria into
the uterine tissues, is removed and a new bleeding area is provided for
further and easy development of the inflammation.
Antiseptic douches seem to be useless, for if they are strong enough to
be germicidal they are likely to injure the tissues and also do harm by
being absorbed into the system; while weaker solutions will not destroy
the organisms but are likely to carry more infective material up into
the uterus. In cases of putrid endometritis, however, if the doctor
cleans out the uterus with his finger, a douche of sterile salt solution
is often given for the purpose of removing any putrefactive material
which may have been left behind.
=Phlegmasia alba dolens or “milk leg.”= In some cases of puerperal
infection, thrombi are formed in the veins of the pelvis, from which
particles may be broken off and carried to various parts of the body and
cause phlebitis or even abscesses. If thrombi lodge in the large vessels
of the thigh, the interference of the venous circulation results in
swelling and tenderness of the leg which is often referred to as “milk
leg.” This condition is rather rare and does not usually appear until
the second or third week after delivery.
The swelling ordinarily starts at the foot and gradually extends up to
the thigh. The patient complains of pain in the calf of her leg and she
may have an elevated temperature, rapid pulse and the general
wretchedness associated with an infection.
The main feature of the treatment is rest in bed; the patient should be
kept there for at least a week after her temperature becomes normal; her
leg should be elevated, wrapped in cotton batting and the bedclothes
held from it by means of a bed cradle or some sort of a light frame. The
nurse should never rub the affected leg, and the patient should also be
cautioned against this for fear of dislodging a particle of the thrombus
and causing an embolism elsewhere, possibly in the lungs. For the same
reason, the patient must be warned not to make sudden or violent
movements for some time after she is allowed to be up and about, but to
walk and move rather slowly. The swelling and discomfort may subside in
a few weeks or they may persist for months.
Public-domain text, read in full here on John Shaqi.
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