Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
_Symptoms_ usually begin before the second week. There is constipation
with small ribbon-like stools, and the urine is scanty. The most marked
sign, however, when it is present, is the excessive, uncontrollable
vomiting, which ordinarily occurs fifteen to thirty minutes after
eating, but may be delayed for several hours. The vomiting may be of the
common type, but more frequently it is projectile in character, like
that seen in meningitis. The contents of the stomach are violently
expelled, sometimes several feet. Physical examination may reveal the
stomach bulging under the arch of the ribs and peristaltic waves moving
back and forth across its surface. The pylorus itself may sometimes be
felt as a lump or tumor.
_Prognosis._—About fifty per cent die.
_Treatment._—Dietetic and surgical. Grulee recommends small amounts of
food, poor in fat, be given at short intervals. If this fails, operation
is required.
=Pneumonia= in the newborn most frequently results from the aspiration
of mucus out of the maternal passages as the child is born. This may
happen when the cord is compressed, or at any time when a partial
asphyxiation impels the child to try to breathe.
It may also come on when a feeble child has been chilled by a prolonged
first bath.
The disease develops about twenty-four hours after birth in a child
apparently well. The temperature rises, respiration becomes rapid, and
cough develops. The child is fretful, restless, refuses the nipple, and
gasps for breath. It may become cyanotic. The prognosis in newborn
infants is very serious.
_Treatment_ is stimulation. A mustard bath will benefit where the
respiration is rapid and the child blue. Tincture of digitalis may be
administered in drop doses every three or four hours. Carbonate of
ammonia, ¼ gr., in mucilage of acacia, half a dram, may be given for
cough.
Child must be fed on mother’s milk _pumped from breast_.
=Snuffles= may be due to improper clothing, to drafts of air, or to
syphilis. If due to cold, camphorated oil may be rubbed on the nose and
the passages kept clean with an applicator soaked in albolene. If this
fails, a small pellicle of anæsthone may be placed in each nostril, and
the child laid upon its back until the ointment melts and runs back into
the pharynx.
=Furuncles= (boils) may be numerous. They come from irritation of the
skin by atmosphere, soap, water, and clothing, whereby infection enters.
This is especially liable to occur in the hair.
Keep the boils washed with boric acid solution and open them as soon as
the focus, or head, appears.
=Phimosis= is such a close adjustment of the prepuce to the glans penis
that it can not be retracted. In some cases there may be obstruction to
the outflow of urine, but generally a tiny portion of the glans can be
seen. The prepuce may or may not be redundant. This condition makes
cleanliness impossible and balanitis may result.
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