Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
The nerves of the patient are highly sensitized, and therefore she
should sleep as much as possible at night, and take an additional nap in
the afternoon. Only the members of the family should be allowed to see
the patient the first week, and they but for a short time. It takes the
strength of the patient unnecessarily to see guests even though they be
close friends. Importunate visitors may be pacified frequently by a view
of the baby. The patient must be spared all household responsibilities,
and if necessary, the nurse must take charge. Tact must be used to avoid
being dictatorial, either to family or servants. If anything unusual
arises, the nurse must show no surprise, annoyance, or bewilderment.
Everything is attended to quietly, firmly, and without friction.
=Getting Up.=—It is a tradition that the woman is lazy who does not get
out of bed by the ninth day.
There are three factors to be considered, the progressive involution of
the uterus, the strength of the patient, and the presence of stitches.
Involution may be complete on the fifth day, but the prostration from
the labor may make the woman indifferent to arising. She may be strong
enough to rise on the third day, but the uterus is large and heavy, and
the erect position will put an unnecessary strain on the supports which
may retard involution and cause displacement or disease later. Also, it
is not desirable for a woman to sit up until her perineum is well on the
road to restoration.
In general, the woman should not get up until the uterus has gone down
into the pelvis and is nonpalpable. If this is the case on the fifth day
and she feels strong, she may get up. If she is not strong, time will be
saved by staying in bed until her vigor returns, whether it is ten days
or twenty.
Getting up may be followed by a return of the bloody discharge. This may
come from subinvolution, from a relaxed and flabby uterus, from a
cervical tear, or from change in posture.
If there has been a retroversion before pregnancy, lying prone with an
occasional knee chest position for a few moments will aid. Massage and
passive exercises while in bed will aid the patient to recover and to
maintain her strength. Even after she is up and about, she should lie
down frequently during the day and always when nursing the babe, until
she feels quite normal again.
For the hospital the following standing orders may be followed:
=Standing Orders—Puerperium=
_Breasts:_
1. Prepare for lactation 12 hours after delivery.
(a) Clean breasts and nipples with soapy water and green soap.
(b) Sponge with sterile water.
(c) Sponge with boric solution.
(d) Sterile compresses over nipples and adjust binder.
2. Babe to breast immediately after breast preparation.
3. Every morning apply fresh compresses over nipples and oftener,
if necessary.
Public-domain text, read in full here on John Shaqi.
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