Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=Constipation= in the newborn may come from many causes. The amount of
food may be so inadequate that no residue is left, and the bowels move
only once in forty-eight hours. Over-stimulation of the bowel by castor
oil or colonic flushings in the early weeks of life to correct colic may
diminish its sensitiveness and produce atonic constipation. In the
artificially fed infant too much fat in the food is a very common cause
of the trouble.
_Treatment._—Correct the amount of fat in the milk. If the child is
breast-fed, the mother’s diet should be non-nitrogenous and vegetables
should preponderate. Drugs should not be given until all else has been
tried. Gluten suppositories will furnish a mild irritation to the
rectum. Orange juice and prune juice may be given, or Mellin’s food or
oatmeal water added to the milk. Milk of magnesia ½ to 1 teaspoonful, or
Husband’s magnesia, in same dosage, may be given daily. Senna is also
efficacious.
=Diarrhœa= is generally significant of an error in diet which is usually
a plain indigestion, though there may be too much sugar in the food.
The stools are more frequent and always softer than usual, possibly
fluid.
Diarrhœa means increased intestinal action due to irritation from
_something_. It may be due to indigestion, to the presence of hard
curds, to acidosis, or it may accompany almost any disease of infancy as
a symptom merely. The odor is due to gases formed in the canal by
bacterial action. There is but little odor in fermentation, but much in
putrefaction. Mucus appears either as balls or strings. The balls come
from the small intestine, strings from colon. Blood indicates ulceration
at some point in the bowel, or an erosion just above the sphincter.
[Illustration: Fig. 127.—Proper position for introduction of a
suppository. (Grulee.)]
Fatty curds may be either white, granular, sand-like masses, or small,
soft, and yellow. The protein curd is large and smooth, or white and
bean-like. Both occur only when the artificially fed infant is given raw
milk (Brenneman). If the milk is boiled for two minutes these masses
will not form.
The cause must be determined. The frequent stools, however, are
exhausting, and may have to be checked with opiates or mechanical
astringents.
When due to indigestion, all food by mouth may be stopped for two or
three days and only barley water administered.
In a breast-fed child, diarrhœa is sometimes checked by diluting the
milk with a little barley water, given just before nursing. With these
infants, not much change in the sugar content can be made by alterations
of the maternal diet, but where artificial food is used, the amount of
sugar is easily reduced to a satisfactory degree.
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