THE BLADDER

Category: Obstetrics or Midwifery

If the patient is not able to pass urine it should be drawn
once in eight or twelve hours or oftener if required. A No.7 rubber
catheter is best. After it has been used, it should be sterilized by
boiling and then kept in a bichloride solution (1-2000). It should be
washed off with boiled water again before being used to remove the
bichloride solution and greased with sterile oil. The parts should be
exposed to pass the catheter, the labia separated by the finger and thumb,
and the opening of the urethra and surrounding parts bathed clean with an
antiseptic solution; unless you are clean decomposing discharges from the
vagina may be introduced into the bladder and a cystitis set up. The care
of the bladder is very important. It is not so sensitive after the labor
and the woman may have urine when she does not think so. Sometimes she
passes a little after trying and then thinks there is no more in the
bladder. Even the attendants are deceived sometimes. I once had a case
where the mother was the nurse. At each visit I inquired as to the amount
of urine passed. I was told each time it was sufficient. She suffered
severely the second day in the evening. I went to see her and against the
protests of the mother I used the catheter and took away an enormous
quantity of urine. In such cases the bladder should be emptied slowly to
save the woman from shock.

A physician cannot always depend upon the patient's knowledge of her
condition even in such matters and sometimes even the nurse is at fault.

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