Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
_Symptoms._—A child with congenital syphilis will show the eruption of
coppery spots, blisters on palms and soles, deep cracks on the feet,
snuffles, cracks and ulcers around the mouth and rectum, and the weakly,
marasmic condition of the body.
The diagnosis in suspected cases can be rendered more certain by the
Wassermann reaction. This is a laboratory test of the blood which should
always be made before a wet nurse is allowed to nurse a child, or before
a suspected child is nursed by a clean woman. In all cases of
transfusion of blood, it is imperative.
_Treatment._—Antisyphilitic treatment of an infected mother or child by
salvarsan, mercury, and potassium iodide must be carried out vigorously
in all cases.
The syphilitic patient must be prevented from spreading the infection by
having dishes and utensils of her own, which are kept sterile.
Discharges are collected and burned, and the nurse in charge of these
cases must carefully cover her hands with rubber gloves, and see that
all cracks and fissures are properly protected from contact with sources
of infection.
=Gonorrhœa= is an acute or chronic disease of the mucous membranes due
to a germ called the gonococcus.
Beginning with a sharp inflammatory disturbance of the urethra or
vagina, it may pass slowly up through the genital passage and produce
chronic and permanent disabilities, such as sterility, pus tubes, and
pelvic peritonitis.
_The symptoms_ are painful urination, painful inflammation of the
vagina, with a purulent discharge. During pregnancy all these symptoms
are intensified, and warty growths (condylomata) may appear on the
vulva.
If infection occurs after pregnancy has begun, the course of the
gestation is rarely affected, as the uterus is closed to germ invasion.
During delivery, however, there is a serious danger of infection of
mouth or eyes of the child if they come in contact with the discharge.
_Prophylaxis._—The eyes at birth must be immediately instilled with a
drop or two of 1 per cent solution of silver nitrate in water. This is
_not neutralized_ by normal saline. Great care must be used that the
discharge does not come in contact with the eyes of the mother or
attendants, lest infection follow.
_Treatment._—Scrupulous cleanliness must be observed. Douches of
potassium permanganate, 1:5000, or painting the vagina with iodine or
solution of silver nitrate, or suppositories of argyrol or protargol
furnish the best means of treatment before labor.
Neither syphilis nor gonorrhea is _necessarily_ caused by venereal
infection. They may be spread by barbers, dentists, physicians, and
nurses,—by anyone who is unclean; and may be acquired innocently
everywhere.
These diseases should not be discussed by the nurse or physician except
with the patient. Certainly nothing from the sick room should be
repeated elsewhere.
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