Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
In a warm room, away from drafts, the nurse takes the child in her lap,
or on a table, with a blanket underneath. She first anoints the child
all over, either with benzoated lard, liquid albolene, sterile vaseline,
or olive oil. This softens the vernix caseosa that covers the child and
aids its removal.
The skin is wiped carefully with cotton or a soft cloth, paying
particular attention to the folds of the groin, the arm pits, and the
genitals. The nostrils are gently wiped out with applicators dipped in
oil.
The child must be covered as much as possible during the operation and
the work finished quickly. The whole period should not exceed twenty
minutes.
During the cleansing process the nurse should look closely for anomalies
or anatomical imperfections, like an imperforate anus or urethra,
supernumerary digits, etc.
=The Bath.=—Daily, until the cord comes off, the baby is sponged with
oiled pledgets, followed by a spray bath, or a sponging with lukewarm
water and castile soap. The child must not be put into a full bath tub
on account of danger of infecting the umbilicus. The bath water in a tub
or basin quickly becomes filled with bacteria from the surface of the
child’s body and may be conveyed quite easily to a raw wound.
[Illustration: Fig. 112.—Rubber bath tub.]
All discharges must be wiped away, and the buttocks cleansed with oil.
If the skin becomes irritated by urine or otherwise, the child should be
well covered with talcum powder, especially in the folds of the groin
and in the genital crease. All infants are benefited by a little mild
massage after the bath.
If other babies are handled, a child with infected eyes, or skin
eruptions, must be quarantined and cared for separately by a special
nurse. The color of the skin should be pink, changing under manipulation
to red. If there is mucus in the mouth, it may be wiped out with an
applicator, if in the throat, the child may be held up by the feet and
the head drawn back for a few minutes so that gravity will aid the
discharge of the obstruction.
After cleansing the skin, the nurse sterilizes her hands and dresses the
cord. The gauze which was temporarily wrapped around the stump is
removed, the cord and adjacent skin washed with alcohol and dried. The
stump is powdered above and at the sides with a mixture of equal parts
of boric acid and subnitrate of bismuth, and then wrapped in gauze. The
band is put on, the temperature taken, and the baby dressed. Some
physicians prefer to have the cord dressed in 95 per cent alcohol, which
is frequently renewed. The normal separation of the cord takes place
through a kind of dry gangrene, which should be favored by dry rather
than wet dressings. The 95 per cent alcohol does not remain at 95 per
cent after it is exposed to air, hence it does not absorb moisture from
the cord as absolute alcohol would. However, the attending man is
responsible, and his orders must be followed.
Public-domain text, read in full here on John Shaqi.
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