Prepping stroke patient w/Go-Lytely through PEG

  1. I had a stroke patient that had just come from ICU. He came to my unit with Go-Lytely on a feeding tube pump through a PEG tube at a rate of 100/hr. He was also ordered 3 enemas for the morning of the colonoscopy if he was not clear. The patient had right side paralysis, was unable to use a call bell, unable to turn and position, and was on an air matress (meaning that he repeatly slid down on the bed and was unable to boost himself back up). He could not turn side to side. He was in a private room. He had no visitors. I continued the Go-Lytely on the pump as it was set from ICU. I work night shift and I informed the nurse coming on at 6AM that although he had bowel movements throughout the night, he was not yet clear, but that the three enemas were ordered. As it turned out, she gave the 3 enemas, he had the colonoscopy and all went as scheduled. I was told by my manager that I should have had the prep completed in 4 hours and that there is no difference between the patient drinking the Go-lytely or having it run through a PEG tube. I explained that he was a stroke patient, unable to use the call bell, unable to be heard from the hall if he was in distress, unable to be in view because of placement of the room, and the whole nine yards. It goes without saying that this patient was receiving prep far slower than a fully functional patient. The last time I prepped a patient through a PEG tube, the patient was alert and oriented, fully functional and I was told to push prep through the PEG throughout the night. Shortly after that was started, the patient was projectile vomiting. Would anyone run Go-lytely in the above patient I described at a rate of 1000/hr? Please keep in mind this is a patient unable to be seen or heard and unable to turn and position. FYI - his Jevity was started today at 20/hr, increasing by 10 every hour until goal of 50. Waiting for your input!
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    Joined: Aug '08; Posts: 13; Likes: 4