A Practical Physiology Part 42

Do not worry the sick with unnecessary questions, idle talk, or silly gossip. It is cruel to whisper in the sick-room, for patients are always annoyed by it. They are usually suspicious that something is wrong and generally imagine that their condition has changed for the worse.

Symptoms of the disease should never be discussed before the patient, especially if he is thought to be asleep. He may be only dozing, and any such talk would then be gross cruelty. Loud talking must, of course, be avoided. The directions of the physician must be rigidly carried out in regard to visitors in the sick-room. This is always a matter of foremost importance, for an hour or even a night of needed sleep and rest may be lost from the untimely call of some thoughtless visitor. A competent nurse, who has good sense and tact, should be able to relieve the family of any embarra.s.sment under such circ.u.mstances.

Do not ever allow a kerosene light with the flame turned down to remain in the sick-room. Use the lamp with the flame carefully shaded, or in an adjoining room, or better still, use a sperm candle for a night light.

Keep, so far as possible, the various bottles of medicine, spoons, gla.s.ses, and so on in an adjoining room, rather than to make a formidable array of them on a bureau or table near the sick-bed. A few simple things, as an orange, a tiny bouquet, one or two playthings, or even a pretty book, may well take their place.

The ideal bed is single, made of iron or bra.s.s, and provided with woven wire springs and a hair mattress. Feather-beds are always objectionable in the sick-room for many and obvious reasons. The proper making of a sick-bed, with the forethought and skill demanded in certain diseases, is of great importance and an art learned only after long experience. The same principle obtains in all that concerns the lifting and the moving of the sick.

Sick people take great comfort in the use of fresh linen and fresh pillows. Two sets should be used, letting one be aired while the other is in use. In making changes the fresh linen should be thoroughly aired and warmed and everything in readiness before the patient is disturbed.

386. Rules for Sick-room. Do not deceive sick people. Tell what is proper or safe to be told, promptly and plainly. If a physician is employed, carry out his orders to the very letter, as long as he visits you. Make on a slip of paper a note of his directions. Make a brief record of exactly what to do, the precise time of giving medicines, etc. This should always be done in serious cases, and by night watchers. Then there is no guesswork. You have the record before you for easy reference. All such things are valuable helps to the doctor.

Whatever must be said in the sick-room, say it openly and aloud. How often a sudden turn in bed, or a quick glance of inquiry, shows that whispering is doing harm! If the patient is in his right mind, answer his questions plainly and squarely. It may not be best to tell all the truth, but nothing is gained in trying to avoid a straightforward reply.

Noises that are liable to disturb the patient, in other parts of the house than the sick-room, should be avoided. Sounds of a startling character, especially those not easily explained, as the rattling or slamming of distant blinds and doors, are always irritating to the sick.

Always attract the attention of a patient before addressing him, otherwise he may be startled and a nervous spell be induced. The same hint applies equally to leaning or sitting upon the sick-bed, or running against furniture in moving about the sick-room.

387. Rest of Mind and Body. The great importance of rest for the sick is not so generally recognized as its value warrants. If it is worry and not work that breaks down the mental and physical health of the well, how much more important is it that the minds and bodies of the sick should be kept at rest, free from worry and excitement! Hence the skilled nurse does her best to aid in restoring the sick to a condition of health by securing for her patient complete rest both of mind and body. To this end, she skillfully removes all minor causes of alarm, irritation, or worry. There are numberless ways in which this may be done of which s.p.a.ce does not allow even mention. Details apparently trifling, as noiseless shoes, quietness, wearing garments that do not rustle, use of small pillows of different sizes, and countless other small things that make up the refinement of modern nursing, play an important part in building up the impaired tissues of the sick.

388. Care of Infectious and Contagious Diseases. There are certain diseases which are known to be infectious and can be communicated from one person to another, either by direct contact, through the medium of the atmosphere, or otherwise.

Of the more prevalent infectious and contagious diseases are _scarlet fever, diphtheria, erysipelas, measles_, and _typhoid fever_.

Considerations of health demand that a person suffering from any one of these diseases should be thoroughly isolated from all other members of the family. All that has been stated in regard to general nursing in previous sections of this chapter, applies, of course, to nursing infectious and contagious diseases. In addition to these certain special directions must be always kept in mind.

Upon the nurse, or the person having the immediate charge of the patient, rests the responsibility of preventing the spread of infectious diseases.

The importance must be fully understood of carrying out in every detail the measures calculated to check the spread or compa.s.s the destruction of the germs of disease.

389. Hints on Nursing Infectious and Contagious Diseases. Strip the room of superfluous rugs, carpets, furniture, etc. Isolate two rooms, if possible, and have these, if convenient, at the top of the house. Tack sheets, wet in some proper disinfectant, to the outer frame of the sick-room door. Boil these sheets every third day. In case of diseases to which young folks are very susceptible, send the children away, if possible, to other houses where there are no children.

Most scrupulous care should be taken in regard to cleanliness and neatness in every detail. Old pieces of linen, cheese-cloth, paper napkins, should be used wherever convenient or necessary and then at once burnt. All soiled clothing that cannot well be burnt should be put to soak at once in disinfectants, and afterward boiled apart from the family wash. Dishes and all utensils should be kept scrupulously clean by frequent boiling. For the bed and person old and worn articles of clothing that can be destroyed should be worn so far as possible.

During convalescence, or when ready to leave isolation, the patient should be thoroughly bathed in water properly disinfected, the hair and nails especially being carefully treated.

Many details of the after treatment depend upon the special disease, as the rubbing of the body with carbolized vaseline after scarlet fever, the care of the eyes after measles, and other particulars of which s.p.a.ce does not admit mention here.

Poisons and Their Antidotes.

390. Poisons. A poison is a substance which, if taken into the system in sufficient amounts, will cause serious trouble or death. For convenience poisons may be divided into two cla.s.ses, irritants and narcotics.

The effects of irritant poisons are evident immediately after being taken. They burn and corrode the skin or membrane or other parts with which they come in contact. There are burning pains in the mouth, throat, stomach, and abdomen, with nausea and vomiting. A certain amount of faintness and shock is also present.

With narcotic poisoning, the symptoms come on more slowly. After a time there is drowsiness, which gradually increases until there is a profound sleep or stupor, from which the patient can be aroused only with great difficulty. There are some substances which possess both the irritant and narcotic properties and in which the symptoms are of a mixed character.

391. Treatment of Poisoning. An antidote is a substance which will either combine with a poison to render it harmless, or which will have a directly opposite effect upon the body, thus neutralizing the effect of the poison. Hence in treatment of poisoning the first thing to do, if you know the special poison, is to give its antidote at once.

If the poison is unknown, and there is any delay in obtaining the antidote, the first thing to do is to remove the poison from the stomach.

Therefore cause vomiting as quickly as possible. This may be done by an emetic given as follows: Stir a tablespoonful of mustard or of common salt in a gla.s.s of warm water and make the patient swallow the whole. It will usually be vomited in a few moments. If mustard or salt is not at hand, compel the patient to drink lukewarm water very freely until vomiting occurs.

Vomiting may be hastened by thrusting the forefinger down the throat. Two teaspoonfuls of the syrup of ipecac, or a heaping teaspoonful of powdered ipecac taken in a cup of warm water, make an efficient emetic, especially if followed with large amounts of warm water.

It is to be remembered that in some poisons, as certain acids and alkalies, no emetic should be given. Again, for certain poisons (except in case of a.r.s.enic) causing local irritation, but which also affect the system at large, no emetic should be given.

392. Reference Table of Common Poisons; Prominent Symptoms; Antidotes and Treatment. The common poisons with their leading symptoms, treatment, and antidotes, may be conveniently arranged for easy reference in the form of a table.

It is to be remembered, of course, that a complete mastery of the table of poisons, as set forth on the two following pages, is really a physician's business. At the same time, no one of fair education should neglect to learn a few of the essential things to do in accidental or intentional poisoning.

A Table of the More Common Poisons,

With their prominent symptoms, antidotes, and treatment.

Poison Prominent Symptoms Antidotes and Treatment

_Strong Acids:_

Muriatic, Burning sensation in _No emetic_ Saleratus; Nitric, mouth, throat, and chalk; soap; plaster from Sulphuric (vitriol), stomach; blisters the wall; lime; magnesia; Oxalic. about mouth; vomiting; baking soda (3 or 4 great weakness teaspoonfuls in a gla.s.s of water).

_Alkalies_:

Caustic potash and Burning sensation in _No emetic_ Olive oil soda, the parts; severe pain freely; lemon juice, vinegar; Ammonia, in stomach; vomiting; melted b.u.t.ter and vaseline; Lye, difficulty in thick cream.

Pearlash, swallowing; cold skin; Saltpeter. weak pulse.

_a.r.s.enic:_

Paris green, Intense pains in Vomit patient repeatedly, Rough on rats, stomach and bowels; give hydrated oxide of iron White a.r.s.enic, thirst; vomiting, with magnesia, usually kept Fowler's solution, perhaps with blood; by druggists for emergencies; Scheele's green. cold and clammy skin. follow with strong solution of common salt and water.

_Other Metallic Poisons_:

Blue vitriol, Symptoms in general, Emetic with lead; none with Copperas, same as in a.r.s.enical copper and iron; white of Green vitriol, poisoning. With lead eggs in abundance with Sugar of lead, and mercury there may copper; with iron and lead Corrosive be a metallic taste in give epsom salts freely; sublimate, the mouth. afterwards, oils, flour, and Bedbug poison. water. _No emetic with mercury;_ raw eggs; milk, or flour, and water.

_Phosphorus from_

Matches, rat Pain in the stomach; _Cause vomiting_.

poisons,etc. vomiting; purging; Strong soapsuds; general collapse. magnesia in water.

Never give oils.

_Opium:_ Morphine, Sleepiness; dullness; _Cause vomiting_. Keep Laudanum, stupor; "pin-hole" patient awake by any means, Paregoric, pupils; slow especially by vigorous Dover's powder, breathing; profuse walking; give strong coffee Soothing syrups, sweat. freely; dash cold water on Cholera and diarrha face and chest.