These foods are sometimes of temporary use. As many of them contain very
little fat, they may be used in cases of illness where fat cannot be
borne. Some of these contain malt sugar, and when the baby is constipated
this kind is useful when added to milk. Others can be made up of water
only, and are useful and handy where it is impossible to obtain fresh
milk. In cases of diarrhea the flour foods made up with water are very
useful. Milk at that time acts as a poison. Some of the best foods on the
market are the following--Condensed milk, Mellin's food, Horlick's Malted
milk, Nestle's food, Imperial granum, Just's food, Carnrick's soluble
food, Ridge's food, peptogenic milk powder, Lactated food, Eskay's,
Albumenized food, cereal milk, Borden's food.
For constipation in a child.--One to two teaspoonfuls of Mellin's food,
added to each bottle of his usual modified milk formula will often help a
great deal. As soon as the bowels move naturally it should be gradually
diminished until after four or six weeks, the child can do without it.
Condensed milk and Malted milk.--These can be prepared with water only,
and so are best to use on a long journey. Give the baby one or two meals
daily a week or two before the journey. Discontinue when at the end of the
journey.
Imperial Granum.--This is often useful in acute diarrhea, when milk cannot
be given. Mix the proportion as given on the box with water into a smooth
paste, then add a pint of boiling water and boil for fifteen or twenty
minutes.
Peptogenic Milk Powder.--This may be used for a short time during or after
acute illness; you can add it to the formula used as directed on the
package.
[NURSING DEPARTMENT 625]
NURSING DEPARTMENT
Including
Care of the Sick and the Sick Room
FOODS, FORMULAE, DELICACIES FOR SICK ROOM,
HOW TO PREPARE THEM; DIET IN FEVERS
AND OTHER DISEASES, SECURED FROM
TRAINED NURSES, PHYSICIANS
AND HOSPITALS.
Every Phase of Nursing Given in Detail and in Plain Mothers'
Language, including Latest Sanitary Care and Science.
VENTILATION.--The sick room should be ventilated without any draught
hitting the patient. The patient's bed should be placed out of the line of
air currents. If this is not possible he must be protected by means of
screens, the head of the bed being especially guarded. That draughts are
dangerous is founded on fact no less than is the modern idea that an
abundance of fresh air is necessary and helpful. A nurse has been guilty
of gross neglect of duty when the patient contracts pneumonia through
exposure to too severe currents of air. A simple way to ventilate a
private room is to raise the lower sash of window six inches and place a
board across the opening below; the air will then enter between the two
sashes and be directed upward, where it becomes diffused and no one in the
room is subjected to a draught. In a room where there is only one window a
pane of glass may be taken out and a piece of tin or pasteboard may be so
placed that the current will be directed upwards; or a window can be
opened in an adjoining room which fills with fresh air and the door of the
sick room opened afterwards to admit the air; or, the patient may be
covered up, head and all, for a few minutes two or three times a day,
while all the windows are thrown open, The room should be thoroughly
warmed before it is so thoroughly ventilated.
[624 MOTHERS' REMEDIES]
TEMPERATURE OF THE ROOM.--This should be regulated by a thermometer
suspended at a central point in the room. The temperature should be
regulated according to the nature of the disease and the comfort of the
patient. In fevers it should be lower, varying from 55 to 60 degrees F.,
but in bronchial troubles it should be kept about 70 degrees F. The mean
temperature should be kept about 60 degrees to 70 degrees. It should be
raised or lowered gradually, so that the patient will not be overheated or
chilled.
LIGHT.--The patient should have plenty of light and sunshine, but do not
let the sun or light shine directly upon the face.
CARE OF THE DISCHARGES (Excreta).--This is very important. Sputa, dirty
vessels, soiled dressings and linen are prolific sources of impure air.
Sputum Cups.--These should be of glazed earthenware, without any corners
or cracks and provided with a simple moveable cover when in use. They
should be sterilized for one hour in every twenty-four hours.
Bed Pans and Urinals.--These should be washed out thoroughly. Allow
boiling hot water to run on them for some time before they are put away
after being cleansed.
Soiled Dressing and Linen.--These should be received in covered basins or
in paper bags and at once carried away and destroyed or disinfected, or
put in a metal dressing can and closely covered until the contents can be
cared for at the earliest possible time. Vomited matter or the discharges
from the bowels and the urine should always be covered in the vessel
either with a lid, towel or rubber cloth. The rubber is better than the
cloth as it keeps in the odor and can be scrubbed and disinfected.
If the patient is too sick to use a sputum cup, the expectoration can be
received in a paper handkerchief or a piece of cheese cloth and placed in
a small paper bag and burned at once.
SOILED AND STAINED LINEN.--These should be put away in a covered
receptacle that contains enough disinfectant solution to keep them moist.
They are removed as soon as possible to the wash room to be cleaned and
sterilized.
Sterilization.--This term is usually employed when heat is used to
sterilize.
Disinfection.--This is the term used when chemicals are relied upon to
purify (sterilize).
Heat and Chemicals are much aided by sunshine, light and fresh air,
especially that of high dry climates.
[NURSING DEPARTMENT 625]
The germs (bacteria) are destroyed by dry or moist heat, the latter used
in the form of steam. Dry heat is not so penetrating and requires a longer
time and some goods are destroyed when exposed in it long enough to
destroy the germs.
In order to destroy these organisms it is thought to be necessary to
expose whatever is to be sterilized to the steam at 200 degrees F. for
three successive days for thirty minutes or more each day, and during the
interval to keep them in a room with a temperature of 60 degrees F.
A SIMPLE METHOD OF STERILIZING.--Put the articles (small articles) in an
ordinary kitchen steamer; closely cover it and place it over a pot of
boiling water. If you wish you can add two parts of carbonate of sodium to
each ninety-eight parts of water.
Germicides are chemicals used to destroy germs.
Disinfectants are chemicals used to arrest and prevent their development.
These disinfectants should always be fresh.
Carbolic acid is one of the most efficient and most frequently employed of
the known chemical disinfectants. It comes to us in the form of white
crystals and dissolves in water, glycerin, or alcohol.
Watery solutions cannot be made stronger than five per cent. Solutions
weaker than this will not destroy all germs, but on account of its
irritating qualities the weaker solutions are employed when used for the
skin and mucous membranes. How to make a five per cent or one to twenty
solution:
A bottle containing the crystals is placed in hot water until they are
melted (or you can buy this dissolved product). Then take one part of the
acid and add it to nineteen parts of boiling water and shake this
vigorously until all has been thoroughly dissolved and mixed. To make a 1,
2, 3 or 4 per cent solution, you take 1/100 or 1/50 or 1/33 or 1/25 of
acid.
Corrosive Sublimate or Bichloride of Mercury.--Tablets can be bought at
any drug store containing the desired strength, and are better to use.
This is a powerful irritant poison and must be used carefully. Tablets of
the strength of 1-1000 and 1-2000 are most often employed for germicide
action. The weaker solutions 1-5,000 or 1-10,000 were used to wash out the
cavities. It is not now used much for that purpose; it stains clothing and
corrodes instruments.
Milk of Lime is considered very valuable and safe to use in vessels to
receive evacuations from the bowels. It should be freshly made or it is
useless. Equal parts should be stirred up with the contents of the bed pan
and this must be let stand at least one hour. This is the best way to
disinfect stools.
To Prepare Milk of Lime.--The milk of lime is made by adding one part of
slaked lime to four parts water.
Chloride of Lime (Chlorinated lime) is also a very good disinfectant. It
has a bad odor and unless it is very fresh, is not reliable.
[626 MOTHERS' REMEDIES]
Boric acid disinfectant. This property is not very marked, but it is not
irritating. The standard solution is five per cent. The weaker solutions
are used to clean cavities, for superficial wounds, and to wash out the
bladder.
The standard or saturated solution is made by using one part of the acid
in crystal form to nineteen parts of water; or, this saturated solution
can be easily made by putting a large quantity of the crystals in a filter
and pouring the quantity of boiling water over them slowly until all are
dissolved. Strain the solution to get rid of the excess of crystals or it
can be allowed to cool when the liquid can be poured off.
Normal salt solution is made by using one teaspoonful of salt to a pint of
water.
CARE AND DISINFECTION OF AN INFECTED ROOM.--Carpets, upholstered
furniture, hangings, bric-a-brac, or any personal clothing, the color of
which may be destroyed by disinfection, should have been removed from the
room at the beginning of the disease.
DAILY CARE OF THE ROOM BY THE NURSE.--The furniture should be wiped off
with a damp cloth and the floor swept with a broom covered with a damp
cloth wrung out of a 1-20 (five per cent) carbolic acid solution; besides
this the floor must be rubbed thoroughly with a damp cloth every second or
third day. If the disease is contagious a damp sheet kept moist should be
hung in the line of the air currents. Cloths that are used daily should be
washed in hot soap suds and when not in use left to soak in carbolic acid
solution 1-20 (five per cent).
After the patient has recovered from an infectious disease he should
receive a hot soap and water tub or sponge bath, thorough washing of the
hair and irrigation of the ears included, followed by a thorough sponging
with a one per cent carbolic acid or corrosive sublimate (1-10,000)
solution. The finger-nails and toe-nails should be cut close and cleaned
underneath.
A nasal douche is given, and the mouth should be washed with listerine or
a saturated (five per cent) solution of boric acid. The patient is then
wrapped in clean sheets or clothes and taken in another room. Then the
bedding and clothing are made ready for sterilization.
DISINFECTION OF THE ROOM.--Brush off the mattress, wrap it in a damp sheet
wrung out of a twenty per cent solution of carbolic acid, and send to the
sterilizer. The clothes are steamed and sent to the wash room. When there
is no sterilizer the bed must be soaked in a 1-20 (five per cent) carbolic
solution, afterwards boiled and the mattress ripped apart and boiled or
burned.
[NURSING DEPARTMENT 627]
DISINFECTING THE ROOM.--Arrange all articles that are left in the room so
as to expose them the best to the fumigating substance. To disinfect with
formalin, close the room tightly, seal all cracks and openings with paste
and paper. Place an alcohol lamp in a metal dish in the center of the
room. Put in a receptacle over the lamp three fluid ounces of a forty per
cent solution of formaldehyde; have a dish of water in the room for some
time; moisten the air of the room, light the lamp and then close the room
up tight for twenty-four hours, until the dust has settled; then enter
gently so as not to disturb the dust and wipe off everything in the room
with a cloth wrung out of a corrosive sublimate (1-1000) solution. Floors,
woodwork, furniture, bedstead must be so washed or wiped, and use for
crevices pure carbolic acid, applying it with a brush. The walls should be
washed down with the 1-1000 corrosive sublimate solution. Then leave the
windows wide open. Sulphur fumigation is not considered so certain in its
results.
HOW TO TREAT SPUTUM FROM TUBERCULOUS PATIENTS.--Sputum is dangerous when
it is dry. The sputum cups should be of china or paper, so that they may
be either boiled or burned. There should be no crevices. The cup should be
kept covered and the sputum moist so that none of the germs on the sputum
becoming dry may escape into the air of the room. The china vessel should
be frequently cleaned and, before the contents are thrown away, the germs
must be destroyed by putting the sputum in a two per cent solution of
carbonate of soda for one hour. The paper cups and contents must be burned
before the contents have time enough to become dry. In infectious
diseases, all discharges from the nose, mouth, bowels and bladder should
be received in a china vessel containing carbolic acid or milk of lime.
In Diphtheria the expectoration, discharge from the nose and vomited
matter should be received in paper napkins and burned at once in the room,
or if this is impossible, boiled before being taken from the room.
Use the same treatment for the discharges in Scarlet fever. Two sets of
cups should be kept and boiled in the soda solution before being used. All
vessels, tubes or cups that are used for the mouth in diphtheria,
syphilis, or cancer should be kept in a 1-40 solution of carbolic acid and
boiled before being used by another patient.
Bed-pans used in cases of cancer, dysentery, typhoid fever and, in short,
in all infectious diseases, are to be soaked in a 1-20 (five per cent)
carbolic acid solution and boiled before again coming into general use.
Sheets and clothing stained with typhoid fever discharges must be washed
out at once, or soaked in a disinfectant solution and steamed before being
sent to the laundry. Also the bedding and clothing in any infectious or
malignant disease should always be put to soak, at once, in a 1-20 (five
per cent) carbolic acid solution, or else steamed or boiled before being
brought again into general use.
The urine needs the same attention as the bowel discharges in typhoid
fever.
Coughing in diphtheria, lung tuberculosis, scarlet fever, etc., sets free
infectious germs. These may be received in the person of the attendant, or
on the bedding and furniture. Care should be taken when attending such
cases.
[628 MOTHERS' REMEDIES]
CARE OF THE MOUTH AND TEETH.--A weak solution of borax or listerine is
very good. One-half ounce of listerine to a glass of water to be used by
the patient as often as he desires to rinse his mouth. Lemon juice in
solution is very good. For cracks in the mouth, vaselin or cold cream is
good. A few drops of oil of peppermint can be added, or oil of
wintergreen.
For spongy and sore gums.--A few drops of tincture of myrrh added to pure
water may be used. Colorless golden seal in the same way is pleasant and
successful.
Cloths for washing the teeth and mouth are made in small squares of gauze
or old linen. They are best to use since they can be burned immediately
after being used. Wrap one of the squares around the first finger, dip it
into the mouth-wash and insert in the mouth. Go over the whole cavity, the
cloth being passed along the gums and behind the wisdom teeth, thence over
the roof of the mouth, inside the teeth and under the tongue. Use more
than one piece for all this. This is very necessary in typhoid fever. If
the tongue is badly coated, it can be soaked and gently scraped. A good
mouth-wash for general use is the following:
Glycerin 1 dram
Soda 10 grains
5% solution of Boric Acid 1 ounce
BED SORES. Prevention and care of.--Very fat flabby people or thin
emaciated patients are liable to suffer from bed sores. They result from
constant friction or pressure on a certain spot or spots and when the body
is poorly nourished. Moisture, creases in the under sheets, night gown,
crumbs in the bed and want of proper care and cleanliness also are causes.
Bed-sores due to pressure occur most frequently upon the hips and lower
back, the shoulders and heels; those from friction, in the ankles, inner
parts of the knees, or the elbows and back of the head. In patients
suffering from dropsy, paralysis or spinal injuries, or when there is a
continuous discharge from any part of the body, the utmost care must be
taken to prevent bed sores.
Treatment. Preventive.--Cleanliness and relief from pressure. Bathe the
back and shoulders with warm water and soap night and morning and
afterwards rub with alcohol and water equal parts. Dust the parts with
oxide of zinc or stearate of zinc powder, or bismuth mixed with borax; all
are good. If there is much moisture due to sweating or involuntary stools
or urine, castor oil should be well rubbed in addition. The sheets must be
kept smooth and dry under the patient.
[ NURSING DEPARTMENT 629]
Redness of the skin may be the first symptom of this trouble. This may be
followed by a dark color under the skin, and when the cuticle finally
comes off the underlying tissues are found broken down and sloughing. Any
skin scraped or worn off--abrasion--should be carefully washed and a small
pad of cotton smeared with olive oil and stearate of zinc placed over it
and kept there with collodion painted over it; or white of egg painted
over the sore is sometimes very beneficial; also equal parts of castor oil
and bismuth make an excellent dressing. Rubber rings or cotton rings over
the part relieve the pressure. Changing the position is often beneficial.
Treatment of the Sore Proper.--Sponge with clean soft cloths, with a
solution of boric acid or one per cent solution of carbolic acid and the
cavity packed with iodoform gauze, or iodoform, or aristol ointment, over
which apply a layer of borated cotton. Dress the sore daily. If it sloughs
apply hot boric acid dressings every four hours and follow with an
application of castor oil and balsam of Peru. When it is better treat as
any other sore.