Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
A sterile douche bag hangs near the table. A bath tub of hot water must
be provided and a tracheal catheter must be ready for the removal of
mucus from the child’s windpipe. An abundance of hot and cold sterile
water must not be overlooked. In the hospital the following synopsis for
the placing of the linen may be found useful:
=Sterile Linen for Operative Case.—=
Bring patient to foot of bed.
Put in the stirrups. (For breech deliveries _do not_ use stirrups.)
Same order as for normal case except that feet are put in stirrups
instead of on bed.
[Illustration: Fig. 72.—Dorsal position when assistants are available.
(Hammerschlag.)]
Sterile sheet under patient extends now from basin under bed to
buttocks.
Combination pad over field of operation.
Sterile sheet over abdomen.
The genitals of the patient are now cleansed with all care and attention
described for labor. If this has been done within an hour, she need only
be sponged off thoroughly with lysol solution (1 per cent). The feet and
legs are covered with stockings, the body kept warm, and protected by
sheets and blankets, if necessary.
_Every_ operative delivery is preceded by catheterization.
All instruments are boiled for thirty minutes and brought to the table
in the same container in which they are sterilized. The hot water has
been poured off and a cool, weak solution of lysol (0.5 per cent) added.
[Illustration: Fig. 73.—Instruments for artificial delivery of the head.
_A_, Braun’s blunt hook; _B_, Cranioclast (Auvard); _C_, Axis traction
forceps (Webster); _D_, Low forceps (Simpson).]
=Forceps.=—Before using forceps it should be determined that the woman
can not deliver the child unaided, or can not be permitted to do so
without too great expenditure of physical and nervous energy. The exact
conditions must be recognized as to the location and position of the
head, the condition of the fœtal heart tones and the size of the pelvis.
When the head is high up, the axis traction instrument is employed and
patient put in Walcher’s position for the traction.
Axis traction forceps are extremely dangerous to mother and child, and
should be avoided wherever possible.
The following instruments are required:
The obstetric forceps.
2 eight-inch forceps.
6 artery forceps.
1 vulsellum forceps.
1 tissue forceps.
1 needle forceps and 6 needles.
2 vaginal retractors.
1 pair dressing forceps.
1 douche point.
1 silver catheter.
Suture material—both catgut and silkworm gut.
Besides these instruments, the nurse will also have solution basins as
described for normal labor. For operations outside of hospitals, the
nurse need not be clean, as her duties will consist for the most part in
changing solutions, refilling basins, handing towels, etc., all of which
can be done with sterile forceps.
The following summary may be serviceable for advanced study or
reference:
PREPARATION.—
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