The Sick Child : Nursing Records, Medicine and Fever

The Mother and Her Child
by William S. Sadler, M.D., Lena K. Sadler, M.D.

(Page 29 of 44)

Nursing Records

Whether the nurse be the mother, caretaker, practical or professional nurse, a record should always be kept of the condition of the patient. The temperature should be reported at different periods designated by the physician. The pulse should be recorded, the amount of urine passed and the time it was passed, the number of bowel movements, all feedings and the general well being of the child - whether it is restless or comfortable, sleeping or awake, together with the water that he drinks.

The record may be kept, if necessary, on a piece of common letter paper, and should read something like this:

March 26, 1916

7 A. M. Temperature 102; pulse 132; respiration 40; morning toilet; took 4 ounces of milk; 2 ounces of barley water; 1 ounce of lime water.

9 A. M. Enema given; good bowel movement; mustard paste applied to chest, front and back, and oil-silk jacket applied; drank boiled water, 4 ounces.

11 A. M. Took the juice of one orange; temperature 103; pulse 135.

12 Noon. Very listless and nervous; temperature 104. Has coughed a great deal. Gave mustard paste to chest, front and back, and wet-sheet pack.

1:30 P. M. Temperature 101.8; 4 ounces of water to drink; looks better.

3 P. M. Has slept 1½ hours; temperature 102.5; pulse 134; respiration 40; 6 ounces of food given (3 ounces of milk, 2 ounces of barley water and 1 ounce of lime water).

A record like this is a great help to the physician, and such a record may be kept by anyone who can read and write. There are printed record blanks which may be procured from any medical supply house and most drug stores.

Bad-Tasting Medicines

Castor oil has neither a pleasant smell nor taste, and nothing is accomplished by telling the child that it does smell good or taste good. If the patient is old enough to drink from a cup, put in a layer of orange juice and then the castor oil and then another layer of orange juice, and in this way it often can be easily taken. Someone has suggested that a piece of ice held in the mouth just before the medicine is taken will often make a bad dose go down without so much forcing.

A taste of currant jelly, or a bit of sweet chocolate, or the chewing of a stick of cinnamon is a great adjunct to the administration of bad-tasting medicines. All oily medicines must be kept in a cool place and should always be given in spoons or from medicine glasses that have first been dipped in very cold water. Very often the addition of sugar to bad-tasting medicines will in no wise interfere with their action, while it often facilitates the administration of the disagreeable dose. The majority of bad-tasting medicines are now put up in the form of chocolate-flavored candy tablets.

Temperatures and Pulse

The normal temperature of a baby is 98.5 to 99 F. in the rectum. After shaking the mercury of the thermometer down below the 97 mark it is well lubricated with Vaseline and then carefully, gently, pushed into the rectum for about an inch and a half or two inches, and left there for three minutes before removing.

Mothers should exercise self-control in taking the temperature, for nothing is gained by allowing a panicky fear to seize you should the mercury register higher than you anticipated. Notify your physician when the temperature registers above 100 F.

The respirations of a child are fairly regular and rhythmic and occur about forty times per minute during the first month of life and about thirty times per minute during the remainder of the year. From one to two years, twenty-six to twenty-eight is the average. Breathing is somewhat irregular when the child is awake and may be a bit slower when asleep. Before the baby is born the fetal pulse is about 150. At birth it ranges from 130 to 140. During the first month the pulse is found to be from 120 to 140. By the sixth month it gets down to 120 or 130, and from that on to a year the normal pulse beat of the baby is about 120. The pulse is influenced very much by exercise and is often increased by crying or nursing or any other excitement.

Fever

Children get fever very easily - the digestive disturbance of overeating, constipation, a slight bilious attack - all produce fever which disappears quite as suddenly as it came. The first thing to do under such circumstances is to withhold food, give plenty of water to drink, produce a brisk movement of the bowel by giving a dose of castor oil, give a cleansing enema, and treat the fever as follows:

After removing all of the clothes from the child, place him in a warm blanket and then prepare a sponge bath which may be equal parts of alcohol and water; expose one portion of the body at a time and apply the water and alcohol first to one arm and then to the other arm, the chest, one leg, the other leg, the back and then the buttocks. Do not dry the part but allow evaporation to take place, and this, accompanied by the cooling of the blood which is brought to the skin by the friction, readily reduces the fever. Another procedure which may be employed if the fever registers high is the wet-sheet pack which is administered as follows:

Three thicknesses of wool blankets are placed on the bed and a sheet as long as the baby and just enough to wrap around him once, is wrung out of cool water and spread over these blankets. With a hot-water bottle to the feet, the child is then laid down in the wet sheet which is now brought in contact with every portion of his body, then the blankets are quickly brought around, and he is allowed to warm up the sheet - which lowers his temperature.

Another valuable procedure is the cooling enema. Water the same temperature as that of the body, is allowed to enter the bowel and is then quickly cooled down to 90 or 85 F.; in this manner much heat is taken out of the body and the fever quickly reduced.

About the Author

Dr. William S. Sadler M.D. was a well-known American psychiatrist and college teacher in the school of medicine at the University of Chicago. For over sixty years he practiced his profession in Chicago, thirty-three years being associated in practice with his wife, Dr Lena Kellogg Sadler. The doctors were pioneers in the research on the mysterious Urantia Papers.