Is it OK to give baking soda and water to LTC patient without a doctor order?

GLORIAmunchkin72 · Feb 26, 2017

I definitely would not give it.

Long Term Care Columnist / Guide · Feb 26, 2017

Me neither. Not without a physician's order. I don't even slather Calmoseptine on someone's bottom without a provider's OK.

amoLucia · Feb 27, 2017

Well, I give sodium bicarb mixed in water to several residents for reflux. Of course, our 70 year old physician is infamous for his old-timey orders. We also give spoonfuls of mineral oil for constipation. And one resident can even get aspirin PRN for headaches.
Once he ordered an aspirin dosage in "grains" (I was mystified) and he refers to me as the "duty nurse" or "nurse on duty" (I have no idea what that means)

This is an old post but am just seeing it.

I had an old-timey MD who loved ordering oatmeal soaks for each & every skin irritation. You just knew he would order the oatmeal if something was needed. Funny thing is, it WORKED.

Sodium bicarb is like drinking seltzer water, and Alka Seltzer or Bromo Seltzer are in the family. As salty as Alka/Bromo is, I do take Alka on an extremely rare occasion. I mean I must be ACTUALLY wretching, puking or my mouth is doing that sweet-water salivating pre-emesis. It does stop the N/V. A box of baking soda has the recipe for mixing it as an antacid. They are OTC meds and they do WORK! But the sodium content is HIGH!

So I decided to do some investigation:

1 Alka tab = 1916mg sodium; avg dose = 2 tabs. Equals ~ 4Gm sodium! Average diet is 2Gm, so Alka med dose alone would DOUBLE a daily rec sodium intake.

1/8 tsp baking soda = 150mg sodium; avg dose = 1/2 tsp in 4 oz water. A dose is 4 times 1/8 tsp = 1/2 tsp . 4 times 150mg = 600mg. That's more than a quarter of the daily sodium intake.

They do DO the job but with great caution. In all my career, I don't ever remember having an administer order. The sodium intake is just too prohibitive for those with any renal or cardio/pulmonary issues.

And speaking of old-timey meds, this COB remembers writing "grains". Once in a while when writing routine house orders, I would lapse and write "Tylenol gr X q 4 prn" (I would really lapse all the way and write Roman numerals!). Another staff nurse would catch it and rewrite it.

PS - I noticed that my box of Alka Seltzers expired 4/2015. Time for a replacement. But am also calling out for a well-meaning reminder for folk out there to check your own med closets/cabinets for expirations. Esp for prns rarely used, like Benadryl, Maalox, immodium , Kao, Colace, cough syrup, etc. My Benadryl expired 2012 when I needed it for a dermatitis about a month ago. (You do not want to be caught without your Benadryl when you've got an itch!)