diagnostic tests that require npo

Anything that requires sedation (e.g. TEE)

Many upper GI tract studies (e.g. EGD, upper GI)

Stress tests (with the exception of some meds--when in doubt ask the stress test lab)

Certainly not an extensive list, but a start. Ideally, the performing doctor/service will write NPO after midnight orders, but always a good idea to know which tests require NPO in case there are not any orders.

If you try to memorize what tests or procedures need NPO by midnight, it can be anything. But you can try these tip: " ABDOMINAL AREA + SURGERY" -Anything related to it.

Commonly, those that involve SCAN like MRI, Ultrasounds, CT, Nuclear Medicine tests and any procedure that use constrast.

Logic- empty stomach less content, less risk for aspiration during procedure. Risk of vomiting from side effect of contrast or fear could be present.

All invasive procedure that sedate the patient needs to be on NPO by midnight.

Hope this help.

MRI's, CT scans as well as ultrasounds do not need to be NPO, even with contrast.. Many MD's/surgeons are very good about writing NPO orders. If you ever have a question about a pt that is going to surgery, you can always call the Doc or ask your charge.

psu_213 said:

Anything that requires sedation (e.g. TEE)

Many upper GI tract studies (e.g. EGD, upper GI)

Stress tests (with the exception of some meds--when in doubt ask the stress test lab)

Certainly not an extensive list, but a start. Ideally, the performing doctor/service will write NPO after midnight orders, but always a good idea to know which tests require NPO in case there are not any orders.

Agreed, this is definetely a good start! It depends on your floor too, as you progress you will learn those procedures that require it.

We just found out that when getting a CT Scan w/contrast the patient should be NPO for at least 3 hours prior to the test. Some of our experienced nurses didn't know this, clearly they weren't making this very known.

A weird one I learned about the other day - Pyridoxine (Vitamin B6) - this lab requires no vitamins/alcohol within 24 hours and NPO after midnight.

thanks everybody, keep 'em coming, this is helpful!

PediLove2147 said:

We just found out that when getting a CT Scan w/contrast the patient should be NPO for at least 3 hours prior to the test. Some of our experienced nurses didn't know this, clearly they weren't making this very known.

Any CT with contrast? I'm not sure I see this reason for this (then again, if your CT techs are anything like ours, they tend to make things up).

Gallbladder ultrasounds. CTA chest. Lipid profiles I only let them have water. CT abd NPO until they do readicat. I usually call radiology and ask. When in doubt I usually keep them NPO until the doc rounds early. Better safe then sorry. I know my hospital has a list for outpatients that state preps. If I had a scanner I'd upload it.

Sun0408 said:

MRI's, CT scans as well as ultrasounds do not need to be NPO, even with contrast.. Many MD's/surgeons are very good about writing NPO orders. If you ever have a question about a pt that is going to surgery, you can always call the Doc or ask your charge.

With oral contrast they need to be NPO for at least 4 hours, then once the patient drinks the contrast radiology is notified so it can be timed...they typically go 2 hours after the contrast is completed, have their procedure, then can go back to their diet after the test is done. And remember to check for allergies!

HIDA scans require you to be NPO. And *NO* morphine or dilaudid within 8 hours because these medications can interfere with the exam. I also learned that the patient has to lie STILL on a small table for up to 90 minutes...I learned A LOT that morning regarding HIDA scans and the patient couldn't have the test done

Stress tests at my facility do not require you to be NPO, but it depends on the physician. Some write an NPO order, others do not and the patient is allowed to have a light breakfast. And no caffeine within 24 hours before a stress test, that includes cola and chocolate! We put up signs on the patient's door to remind ancillary staff. Certain medications such as theophylline can also interfere with the test.

You do not need to be NPO for a CT that uses IV contrast.

Abdominal ultrasounds including ultrasounds of the GB require you to be NPO, but I'm having a brain fart regarding how long I *think* it is NPO for at least 4-6 hours. I'll get back to you on this one.

Any sort of invasive procedure, such as a bronchoscopy, cardiac cath, paracentesis/thoracentesis, surgical procedures etc require you to be NPO after midnight.

I have a really nice chart on my work clipboard that lists a bunch of tests and their required preparation, including when a patient needs to be NPO. I'll try to bring it home from work tomorrow morning and type up some of the information.

When in doubt, you can always call radiology and ask.

eatmysoxRN said:

Gallbladder ultrasounds. CTA chest. Lipid profiles I only let them have water. CT abd NPO until they do readicat. I usually call radiology and ask. When in doubt I usually keep them NPO until the doc rounds early. Better safe then sorry. I know my hospital has a list for outpatients that state preps. If I had a scanner I'd upload it.

Second to keeping them NPO to be safe rather than sorry. Most patients have no problem with being NPO if you explain things to them. We have a cardiologist who is notorious for coming in late at night to do his rounds and we know he may decide on doing a cardiac cath...I'll explain to the patient the need to be NPO after midnight. It doesn't mean they are consenting to the test, just to be safe rather than sorry. I also throw in that I don't want them to have to stay any longer than they have to and they usually comply LOL

Im studying Documenting Diagnostic Testing for HUC in Canada and I would add colonscopy to the list of NPO after midnight.

Any scopes, abdominal ultrasounds or imaging.

Cardiac stress tests at are hospital are NPO. Surgeries naturally. Some guided biopsies or procedures. Though some facilities I worked at allowed a clear liquid then NPO.