Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
4. Cleanse nipples with boric solution (use applicator) before and
after each nursing.
To dry up milk:
Restrict fluids; give saline cathartics; apply ice bags to
breasts, as needed; for pain give codeine solution ¼ to ½
gr. hypodermically, if necessary.
_Do not massage, do not bind, do not pump. Let breasts alone._
When breast is inflamed:
Apply ice bags constantly until pain subsides and temperature
goes down. Watch for signs of suppuration.
_Genitals:_
1. S.S. enema each morning, followed by aseptic care.
Cleanse from above downward—1 per cent solution of lysol and
cotton pledgets.
1 pledget for each side.
1 pledget for center.
1 pledget for rectum (last).
External douche of sterile water.
Dry sterile pad.
2. Aseptic care following all bowel movements and urination.
_Routine:_
1. Record pulse and temperature twice a day, unless otherwise
ordered.
2. Bladder must be emptied in twelve hours. If all persuasive
means fail (may sit up in bed), catheterize.
3. Make daily records of conditions of uterus (firmness and
height), breasts and nipples.
4. No vaginal douche unless ordered.
5. Diet: liquid two days; semisolid two days; then general.
6. Watch for hæmorrhage.
7. Keep uterus firm by occasional massage.
8. All cases to have castor oil, 1 ounce within thirty-six hours
after delivery (before noon).
9. Woman may get up as soon as uterus can not be felt above pubes,
if there is no contraindication.
The history sheet should be kept accurately and should show every
incident in the course of the lying-in period.
The condition of the bowels, bladder, and lochia, the temperature, pulse
and respiration and the height of the fundus above the symphysis from
day to day must be set down in finger-breadths or centimeters.
For the hospital, the following system will be found useful in
establishing a routine.
=Nurse’s Record=
_First Stage._
1. When pains began.
2. Frequency and duration of pains.
3. Character vaginal discharge.
4. Time membranes ruptured.
(a) Artificial.
(b) Spontaneous.
_Second Stage._
1. Time second stage began and ended.
2. Anæsthetic.
3. Mode of delivery.
4. Who delivered.
5. Sex of child.
(a) Living.
(b) Dead.
6. Perineum.
(a) Condition.
(b) Repair.
_Third Stage._
1. Method.
(a) Spontaneous.
(b) Early expression.
(c) Credé expression.
(d) Manual removal.
2. Placenta delivery.
(a) Time.
(b) Size.
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