DOSE IN DROPS FOR DIFFERENT AGES.
If the dose is a spoonful or 60 drops for an adult, the other doses would be correct for the ages given below:
21 and over 60 drops
15 years about 33 drops A few more or less if robust or weakly
12 " " 30 drops "
10 " " 27 drops "
8 " " 24 drops "
6 " " 20 drops "
5 " " 17 drops "
4 " " 15 drops "
3 " " 12 drops "
2 " " 8 drops "
1 " " 4 drops "
Exceptions to this rule are calomel and castor oil, when half an adult dose can be given between 12 and 18.
Opium is dangerous to children and old people and should be administered by a physician or trained nurse.
"Lest We Forget."
COMMON TABLES OF MEASURES.
APOTHECARIES' WEIGHT.
Apothecaries' Weight is used in prescribing and mixing medicines
Table.
20 grains equal 1 scruple
3 scruples " 1 dram
8 drams " 1 ounce
12 ounces " 1 pound
The pound is the same as the pound Troy. Medicines are bought and sold in quantities by Avoirdupois Weight.
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1 grain equals 1 drop or 1 minim
60 grains or drops " 1 teaspoonful
1 teaspoonful " 1 fluid dram
8 drams (or 8 teaspoonfuls) make 1 fluid ounce
2 tablespoonfuls make 1 fluid ounce
1/2 fluid ounce is a tablespoonful
2 fluid ounces is a wineglassful
4 fluid ounces is a teacupful
6 fluid ounces is a coffee cup
16 ounces (dry or solid) is a pound
20 fluid ounces is a pint
MEDICINE CHEST.—More important than the furnishing of the house is the medicine chest. If you are beginning housekeeping let this be your first consideration. Do not put it off because it is a little trouble and costs a few dollars. Yon would not think of leaving your front room or your "spare room" half furnished. Your health is of vastly more importance than the looks of your best rooms. There may come a time when you cannot secure the doctor for several hours or get into a drug store. Be prepared for this emergency and either fix up a home-made box with shelves, etc., or buy a regular medicine chest; in either case have a lock to it and the key where you can find it but where the children cannot reach it.
We give below a few of the necessaries and you will of course add to this list. One mother writes that she went to the store and bought several tiny little bells and tied one of these bells around the neck of each of the bottles in her medicine chest that contained poison. There was no danger of her getting the wrong bottle in the dark. Contents of the Medicine Chest.
Ten cents worth of Alum.
A small bag of Burnt Alum.
A small bottle of Castor Oil.
A small vial of Bichloride of Mercury Tablets.
A box of Boric Acid Powder.
A $mall bottle of Glycerin:
A bottle of Extract of Witch-hazel
A small bottle of Syrup of Ipecac.
A bottle of Whisky and one of Brandy.
A box of English Mustard.
Medicine glass.
A small box of Cold Cream.
Soft rubber Ear Syringe.
A Clinical Thermometer.
An Eye Stone.
A pad, pencils, and labels.
A small bottle of Carbolic Acid.
A roll of Adhesive Plaster.
A small box of Pineoline Salve.
A bottle of Arnica.
Hung near the chest should be a fountain syringe with the rubber catheter for use in irrigating the bowels and a hot water bag.
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HOW TO CARE FOR THE DEAD.
The limbs should be straightened before the body becomes stiff (rigor mortis). The eyes should be closed and the jaws held in position by means of a support placed firmly under the chin; for this a roller bandage or a small padded piece of wood is generally used. Of course if the person has worn false teeth, and they have been taken out during the last hours, they should be replaced immediately after death. The nostrils, mouth, rectum, and vagina should be packed with absorbent cotton to prevent the escape of discharges after death. After this bathe the body, if so desired by the relatives, with a two per cent watery solution of carbolic acid, and if there are any wounds they should be covered with fresh cotton and neatly fastened with a bandage. The hips may be enclosed in a large triangular binder; the knees are held together by a broad bandage; the hair should be brushed smoothly, and finally stockings and a simple nightgown should be put on. If the case be one of the infectious diseases, wrap the body in a sheet wrung out of a five per cent watery solution of carbolic acid and this sheet should be kept damp.
The room where death occurs should be tidied and regulated to make it look natural and comfortable. The undertaker can be sent for as soon as desired by the family. But if such care as directed has been given, the undertaker need not be hurried.
ENEMA.—Enemata (Injections).—There are various methods used for injecting fluids into the body. When they are introduced into the intestines, we speak of giving enemata (enema is the singular). They are named according to their purpose.
1. Simple laxative or purgative enemata.
2. Nutritive enemata for the purpose of nourishment.
3. Sedative enemata for local or systemic quieting effects.
4. Astringent enemata to check bleeding and diarrhea, like hot water, ice water, solution of alum or nitrate of silver.
5. Emollient (soothing) enemata for soothing irritated and painful mucous membrane; starch and drugs are also used.
6. Antispasmodic enemata to relieve flatulence such as the turpentine enemata.
7. Anthelmintic (against worms) for destroying worms; salt, turpentine and quassia are used.
8. Antiseptic or germicidal enemata used in dysentery.
9. Stimulating enemata, like hot water, hot strong coffee, hot whisky and water, salt water.
10. To relieve thirst, water one pint or normal salt solution (one dram to a pint of water) and injected high up.
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ENEMATA are given either high or low.
A high enemas thrown high up into the bowel.
A low enema is injected into the rectum only, through a hard rubber tip to a syringe.
Directions.—There are many ways of giving a simple enema.
Position.—A good way is to place an adult patient on his left side, with the knees bent up close. Protect the bed with a rubber sheet and towel under the patient. The basin of water can be placed on the rubber sheet and the enema given under cover.
Amount.—An adult person will take one to four pints. A child one-half to one pint. For an infant about two ounces will do.
What material? A simple enema can be made with good castile soap or good brown soap and water, temperature about 95 degrees F. When ready for use make into a good suds.
Syringe.—Use a bulb syringe, see that the syringe is filled full to the nozzle before the nozzle is put into the bowel. Any air left in the syringe will pass into the bowel and cause pain. Oil the nozzle with vaselin or sweet oil and then gently put the nozzle into the rectum. It is better to introduce an oiled finger through the sphincter muscle and pass the nozzle along the finger and gently into the bowel. It should be in the bowel two or three inches. Do not attempt to force the nozzle through any obstruction. Introduce the water slowly in a gentle and steady stream. The main object is to distend the rectum by means of the water, thereby producing reflex stimulation. The worm-like movement of the bowels results, thus bringing about an evacuation. The patient should retain it for ten or fifteen minutes to get the best results. A folded towel placed against the anus will assist the patient in resisting the desire to expel the water. A large amount should be given in one-half hour if the first one does not produce the desired result.
Sometimes a laxative enema is necessary.—Olive oil or glycerin or castor oil may be used.
For olive oil, six ounces may be given in a hard rubber syringe; this is seldom successful unless followed by a soap suds enema in one-half hour.
Glycerin enema, one-half ounce with equal quantity of warm water 95 degrees F., and give with a hard rubber syringe. This generally proves successful, without an additional soap suds enema.
For infants and children the contents of a straight medicine dropper will be sufficient.
Glycerin irritates the mucous membrane, and it is best that we add an equal amount of olive oil.
If these enemata fail it will be necessary to use purgative enemata. These are made by adding drugs, such as turpentine, rochelle or epsom salts or castor oil in certain proportions to the simple enema. In giving castor oil and water it is necessary first to mix the oil with the yolk of an egg and then add the warm soap suds.
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1. Formula.—
Castor Oil 2 ounces
Turpentine 1/2 ounce
Mix thoroughly and inject with hard rubber syringe, followed in one-half hour by a quart of soap-suds.
2. Formula.—
Turpentine 1/2 ounce
Rochelle Salts 1 ounce
Mix with warm soap-suds, one pint.
The buttocks and anus should be washed off with warm water after turpentine has been used in the enema.
3. Molasses and Laxative Enema.—Mix from two to ten ounces, according to age, with one pint of soap suds and inject slowly.
Nutritive Enemata.—Food is given by the bowel when the stomach cannot retain it. It is then called Nutritive Enemata. They should be given only from four to six times in twenty-four hours and the quantity given at one time should not exceed four ounces. It must be introduced high up in the bowel, about ten inches, and therefore they should be given through a rectal tube made of heavy rubber one-quarter inch in diameter and at least eight inches of it should be inserted in the bowel. After it has been oiled the tube is gently inserted in a backward, upward, direction and a glass funnel is attached to the outer end. The enema has been already mixed in a small pitcher and gently poured (very slowly) into the funnel, which is then raised so that the contents will go slowly through the tube into the bowel. The patient is protected from drops by a folded towel underneath him. Then the tube is slowly withdrawn. The tube should then be cleansed by allowing warm water to run through it, and then kept in a one per cent solution of boric acid. Food given by enemata should be very nourishing and concentrated. The following are excellent formulas:
Formula 1.—
One whole Egg
Table Salt 15 grains
Peptonized Milk 3 ounces or 3/8 of a cup
Brandy 1/2 ounce
Formula 2.—
White of two Eggs
Peptonized Milk 2 ounces or 1/4 of a cup
The whole amount should never exceed four ounces. The addition of salt aids the absorption of the egg. Brandy, and whisky are very irritating and should be given only every other time.
The fresh raw milk can be used, if it is impossible to have it peptonized.
After a nutritive enemata the patient should lie quietly on his back for twenty or thirty minutes.
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Turpentine enemata for distention may be given according to the following formula:
Mucilage of Acacia 1/2 ounce
Spirits of Turpentine 10 drops
This should be administered high up in the bowel.
Astringent Enemata. To check diarrhea.—They should be given slowly and injected high up, and they should be retained as long as possible.
Starch and Laudanum.—Boil the starch as if to be used in the laundry and dilute with luke-warm water, until it is thin enough to pass through a tube. Take of this three ounces. This can be given alone in mild cases; but if there is much pain and straining add ten to fifteen drops of laudanum to the starch water or thirty to forty drops of paregoric. This dose is for an adult.
Stimulating Enemata. 1. Black coffee.—One-half to one pint of strong coffee, injected as hot as possible. It should be strained before using. This is frequently given in poison cases.
2. Salt Enemata.—Two teaspoonfuls to one quart of hot water is mildly stimulating; one-half to one ounce of brandy or whisky may be added.
DOUCHES.—By this term is generally meant a jet of fluid directed with a certain amount of force upon a limited external or internal surface, for cleansing, stimulating purposes and to relieve inflammation. Three common douches are the ear (aural), the vaginal and the rectal.
The Vaginal Douche. For cleansing.—A one per cent solution of carbolic acid is often used in one to three quarts of water.
To allay inflammation.—A hot solution of the temperature of 105 degrees to 115 degrees is given, and three or six quarts may be used. Allow the stream to flow before the nozzle is inserted so as to have the warm temperature instead of cold at the start, and the nozzle should be introduced up towards the posterior vaginal wall. The fountain syringe bag should not be raised more than six to twelve inches above the patient who is lying down with her hips raised on pillows and her knees drawn up. Medicines can be used in all the douches.
Rectal douche.—This is to relieve piles and reduce inflammation. Hot or cold as needed. A rectal tube or fountain syringe is used.
Ear (aural) douche.—This is used for earache and inflammation. Salt or boric acid is generally used in the warm water. It should be allowed to flow in slowly and gently.
How to use a bed pan.—When you are placing the pan, you should slip one hand under the buttocks and then place the flat end of the pan under the buttocks. It should always be warm. Raise the patient in the same way before attempting to remove it. Do not pull it out.
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TEMPERATURE (Fever).—A thermometer is necessary in taking the temperature. They can be bought for from fifty cents up. The temperature is taken by putting the thermometer under the tongue, in the arm-pit and in the rectum. For children it should be placed in the rectum or in the arm-pit or groin. Allow it to remain from two to five minutes. This depends upon the time limit of the thermometer. The normal temperature is 98-6/10 degrees F. This varies, some people are normal at times at 99 or 98 degrees. The temperature in the arm-pit is lower by 3/10 of a degree, but that in the rectum is 1/2 degree higher than that taken in the mouth. The normal point on the thermometer is marked by an arrow. The mercury in the tube must always be down to that at its highest point, before the thermometer is placed and the highest point the mercury goes indicates the height of the temperature (fever). If you take it in the rectum, that should be free from feces. Oil the thermometer and gently insert it into the bowel for one and one-half inches and hold the stem.
Under the Tongue.—Place the point under the tongue and instruct the patient to close his lips over the thermometer. He can also hold the stem with his fingers, It should never be taken here right after a cold drink. Unconscious patients may bite through the instrument, so care must be taken with them.
Arm-pit.—Wipe the part thoroughly dry and place the point directly in the arm-pit. Then place the elbow against the body and the hand on the chest pointing to the opposite shoulder. When ready to take it out move the arm away from the body and take the thermometer away gently for it sticks sometimes and you will cause pain if you draw it away quickly. The instrument should be cleansed in tepid mild salt solution.
PULSE.—Average in men, sixty to seventy. In women, sixty-five to eighty. Children ninety to one hundred to one hundred and twenty. Different authors vary. In men it is generally seventy to seventy-two. In women seventy-two to seventy-five.
It is better taken sitting. It is faster when walking, slower when lying down. I always take the pulse in the left arm unless there is a deformity there. I use my right hand with the third finger toward the elbow. By using the first three fingers you can find out different things about the pulse. Some people are very nervous and such an one will make your arm ache when feeling the pulse. The pulse should be regular, even beats, in health. Sometimes you can feel it best on the temple or on the neck.
RESPIRATION (Breathing).—In an adult the average is eighteen per minute. In a child the average is twenty to twenty-four. Respiration is the act of taking in (inspiration), and giving out (expiration) air by the lungs.
THE TONGUE.—This is coated in dyspepsia and fevers,—some healthy persons always have a coated tongue.
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In Ulcers of the stomach there is no coating.
In high fevers, the tongue may also be red and cracked as well as coated in some parts.
A dark brown or blackish coating indicates a serious condition in acute diseases.
Strawberry tongue is seen in Scarlet Fever.
Cankered tongue and month may be due to local conditions, or to stomach, liver and bowel disorders.
In Peritonitis the tongue is generally dry and red (beefy).
Cholera Infantum.—At first coated, then dry and reddish.
Constipation.—Tongue is generally coated.
Biliousness.—Yellowish dirty coating.