Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=Wheals, urticaria or “stomach spots”= appear as generally distributed
small spots about the size of a split pea, with a white center and a red
periphery. They appear about the third day and last twenty-four hours.
They may be mistaken for insect bites and they may, or may not, be
accompanied by temperature, which is probably only a coincidence.
The wheals disappear spontaneously without treatment.
=Bednar’s disease= is characterized by the appearance of two ulcers on
the hard palate, one on either side and just above the spot where the
last tooth will erupt. It is most liable to occur in sickly infants and
supposedly arises from the abrading of the mucous membrane by a rubber
nipple or through the rough cleansing of the mouth. It is very resistant
to treatment. The child must be put in good condition by attention to
the nourishment and the spots touched with tincture of iodine on an
applicator.
=The exudative diathesis= is indicated superficially by a definitely
bounded red patch on either cheek, which is not relieved, or only
temporarily, by the common ointments and powders. The mother says the
“face is chapped,” or that the baby has a “milk eczema.” Otherwise the
skin is pale.
These children are frequently fat, but the tissue is flabby. The urine
is sometimes ammoniacal. There is no marked disturbance of temperature.
Fretfulness and constipation are the principal symptoms.
The condition is due to too much fat in the food. A skimmed-milk diet is
best for a time. The fat can be added gradually until the limit of
tolerance is found.
If chalky masses appear in the stools, the fat must be reduced again.
Occasionally the child must be taken off the milk entirely, and a soup
or gruel diet substituted.
For local application, the following formula is sometimes beneficial:
(Grulee.)
℞ Naphthalene ℥i
Starch ʒiv
Zinc stearate ʒiv
M.
Sig. Apply frequently.
=The “cradle cap”= is a frequent sign of the exudative diathesis in its
milder stages.
The term is applied to a yellowish-gray patch over the large fontanelle.
The mother calls it “dirt,” which she finds hard to remove and it always
recurs. The mass is composed of dry scales, which gradually change into
an eczema. Vaseline or sweet oil left on over night makes the removal of
the scales quite easy the next day. If a raw surface is left, zinc
ointment should be applied. The diet must be changed as previously
described.
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