Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=Weight.=—The weighing of the child should precede, for convenience, the
first cleaning of the skin and the daily bath. The child is either put
on the scale naked or weighed in a blanket, and the weight of the
blanket, ascertained before or after, is subtracted. The daily weight
record is just as important as the temperature. A scale that registers
ounces and fractions thereof must be used, and the child should be
guarded from falling during the performance. Usually the child loses
from eight ounces to a pound the first week, but it should gain back to
its birth weight, by the end of the second week. If the child does not
gain, it may be due to lack of milk from the breast, and the weight may
be taken before and after feeding to verify or refute the suspicion.
=The mouth= should be inspected each morning, but not cleansed with the
boric acid solution unless definitely indicated. Spots or any unusual
appearance should be reported.
=The Genitals.=—The vulva of the female infant usually requires but
little care besides cleanliness. There is sometimes a whitish discharge
which disappears spontaneously in a few days. It is a drainage of
vernix, smegma and epithelium from the vagina and labia.
With a male, the prepuce must be inspected when the child is about a
week old. If it is long and the orifice small, circumcision may be
suggested. Under any circumstances, the foreskin must be retracted, the
adhesions broken up, and the smegma removed. This must be repeated daily
until the adhesions do not recur. The maneuver should be done the first
few times by the physician, for fear of a paraphimosis.
=Sleep= in the newborn is normally quite deep and almost continuous,
probably twenty-two hours a day, for the first week. The rather fast
respiration of the child, even when sleeping, is no cause for alarm. A
healthy infant breathes about twenty-five times a minute. The child
should not be rocked, carried about, exhibited, or handled more than
necessary. It should not sleep with the mother, lest it become too hot
or too cold, be overwhelmed by bedding, or overlaid by the mother.
=Bowels.=—The first stools are black and tar-like,—this is meconium. It
disappears by the end of the first week. The presence or absence and the
character of an evacuation, as well as the number in twenty-four hours,
must be daily recorded. For a breast-fed child, there should be three or
four a day, for the first ten days and the number should gradually
diminish until a routine of two a day is obtained.
=The diaper= of bird’s-eye linen should be large and thick; two may be
used if required. They should be carefully washed after soiling. Bluing
must not be used, because where this substance comes in contact with the
skin, irritation follows.
=Weaning= should be brought about by the gradual substitution of other
foods, somewhere between the sixth and twelfth months.
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