Read Ebook: A reference hand-book for nurses by Beck Amanda K Amanda Kathryn

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Ebook has 588 lines and 72352 words, and 12 pages

In large doses alcohol in any form causes mental excitement, delirium, loss of co-ordination, and finally stupor and coma. Death may result from paralysis of the heart or respiration.

The injections are sometimes followed by a rise of temperature, pain in the joints, or a cutaneous rash, but these symptoms are without serious significance.

There are two simple methods of taking castor oil without producing nauseating effects. Have the patient wash out the mouth with water as hot as can be borne, then swallow the oil, and follow this by rinsing out the mouth well with hot water. The other method is to hold a piece of ice in the mouth long enough to chill the lining membrane, swallow the oil, and rinse the mouth with ice-water.

Poisonous doses cause unconsciousness, embarrassed breathing, and collapse.

A 2 1/2 -grain tablet of cocain, dissolved in a teaspoonful of water, makes a 2 per cent. solution; a 4 1/2 -grain tablet, in the same amount of water makes a 4 per cent. solution; a 10 1/2 -grain tablet in a like amount furnishes a 10 per cent. solution. These percentages are not mathematically correct, but are sufficiently exact for any surgical purposes.

Death from ether is usually the result of asphyxia, and not, as in the case of chloroform, from heart failure. Internally, by the mouth or hypodermically, ether is sometimes used as a circulatory stimulant in sudden heart failure. Great care should be exercised in handling ether in the neighborhood of lighted gas-jets, as the vapor of the drug is highly inflammable. Ether should be stored in well-stoppered containers, in a cool place, remote from lights and fire.

The limit of tolerance is indicated by restlessness, stiffness of the neck muscles, and jerking of the limbs. Toxic doses cause violent spasms closely resembling those of lock-jaw or tetanus. The convulsions of strychnin-poisoning, however, come and go, the muscles being completely relaxed in the intervals, and, moreover, they rarely involve the muscles of the jaw.

Opium depresses the brain, depresses the respiration, stimulates the heart slightly, lessens the peristaltic movements of the bowel, and diminishes all secretions, except the sweat. It is employed to induce sleep, to relieve pain, to allay cough, to check diarrhea, and to promote perspiration.

Even after small doses of opium many patients suffer from headache and nausea. Children are much more sensitive to its action than adults. Morphin resembles opium in action, but is more powerful, less nauseating, and less constipating. Codein is less powerful as a hypnotic and less depressing than morphin.

The prolonged use of the drug, even in small doses, is followed by a permanent grayish discoloration of the skin from the precipitation of the metal in the tissues.

Toxic doses of silver nitrate cause burning pain in the abdomen, vomiting of white, curdy matter, and bloody purging.

DOSAGE.

The following general rules will aid the student in remembering the safe dose of many important preparations:

TO ASCERTAIN DOSES OF MEDICINE FOR CHILDREN.

The following rule of Young is sufficiently accurate for most drugs: Add 12 to the age and divide by the age to get the denominator of the fraction, the numerator of which is 1. Thus, for a child of two years,

For children up to twelve months of age, Young's rule may be worked out as follows: Add 144 to the age in months, which sum becomes the denominator of the fraction, the numerator of which is the child's age. Thus, for a baby of eight months,

for a baby of six months,

The following table, based on Young's rule, is sufficiently accurate in ordinary cases, and its use will avoid the necessity of mathematic calculations on the part of the physician:

Child aged one month ?/??? of an adult's dose. " " two months ?/?? " " " " " three months ?/?? " " " " " four months ?/?? " " " " " five months ?/?? " " " " " six months ?/?? " " " " " seven months ?/?? " " " " " eight months ?/?? " " " " " nine months ?/?? " " " " " ten months ?/?? " " " " " eleven months ?/?? " " " " " twelve months ?/?? " " " " " two years ?/? " " " " " three years ?/? " " " " " four years ?/? " " " " " five years ?/?? " " " " " six years ?/? " " " " " seven years ?/?? " " " " " eight years ?/? " " " " " nine years ?/? " " " " " ten years ?/?? " " " " " eleven years ?/? " " " " " twelve years ?/? " " "

Of powerful narcotics, such as opium, scarcely more than one-half of this proportion should be used. In the case of mild cathartics, however, two or even three times this proportion may be given.

THE DOSE OF DRUGS ADMINISTERED SUBCUTANEOUSLY AND BY THE RECTUM.

PROPER TIME TO TAKE MEDICINES.

POISONS AND ANTIDOTES.

Mercury bichlorid, gr. v; Ammonium chlorid, gr. v; Aqua, ?ij.

ANTIDOTES.

MISCELLANEOUS FORMULAE.

Sodium iodid, gr. xv; Sodium phosphate, gr. xxx; Sodium chlorid, gr. cx; Aqua, ?xxxvj.

A diuretic and laxative mixture.

NORMAL SALT SOLUTION.

Stock salt solution is kept for the purpose of making normal salt solution quickly and accurately. Use sodium chlorid dried sufficiently to granulate.

Stock Salt Solution by Weight.

Sodium chlorid, ?jss ; Water, f?viij .

Boil in a closed vessel fifteen minutes. When cold make up with sterile water to f?j-viij. Strain through sterile cotton into a sterile bottle, and keep tightly corked.

Normal salt solution should contain 90 grains of salt in 1 quart of water.

Normal Salt Solution.

Stock salt solution, f?j ; Sterile water, Oij .

Salt Solution.

Distilled water, Oiv; Purified salt, ?xij.

CARBOLIC ACID SOLUTION .

Cold sterile water, gal. j; Carbolic acid , ?iv.

Sterile glycerin, ?viss ; Solution formaldehyd, Oj .

SOLUTION OF BICHLORID OF MERCURY .

Mercury bichlorid or corrosive sublimate, gr. xv ; Common salt, gr. xv ; Sterile water, Oij .

The salt in this formula is added to prevent decomposition of the mercurial salt by the albuminous juices of the tissues.

ALKALINE SOLUTION OF CYANID OF MERCURY.

Some surgeons recommend cyanid of mercury in solutions of 1: 1000 or 1: 2000 in place of the bichlorid of mercury. It is a powerful antiseptic that does not coagulate albumin, irritate the tissues, or attack metals.

Mercury cyanid, gr. viiss ; Sodium borate, gr. xv . These tablets are made to correspond to bichlorid tablets.

Compressed tablets, each containing 7 1/2 grains of corrosive sublimate with tartaric acid, are also in common use. One of these added to 1 pint of water makes a solution of 1: 1000.

SATURATED BORIC OR BORACIC-ACID SOLUTION.

Boric acid crystals, ?jss ; Hot sterile water, Oij .

This solution may also be made by putting an excess of the crystals into the water, then sterilizing by boiling twenty minutes and straining through sterile cotton.

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