Have you ever given a pt go lytely and had it not work?

to finally run clear stool, it wasn't that she wasn't going, it was that we couldn't get her to clear for a colonoscopy. However, if she hasn't even started cleaning out yet and has been on a clear liquid diet for at least 24 hours prior to starting, she may have an obstruction???? Just a thought.

Jamie

Stupid question, but is the NG clamped?

I had a pt sometime ago who had had his appendix out(dr thought that was his cause of abd pain). No relief....x-rays etc, then proceed to goltyley x2 gallon with still no result??????????long story short dr missed several inches of necrotic bowel, ie pt is very bad shape after surgery(hx of severe COPD and ventiliation). Only one instance, many of my pts it was coming up both ends continuouly.

My only r/t exp with Go GO juice was when I was a newbie on the ortho floor and we had a male pt s/p ORIF of hip fx. He was mildly MR and 2 days out his belly began to swell and swell. So MD ordered NG tube and Go Go juice via NG tube. Every 2hr round we would give him a few 60cc syringe fulls of the stuff when we turned and repositioned him. Now I was working 11p/7a at the time and right at 6am the orderly and myself got him up to a BSC and I swear he ran it over.....I thought man he has got to feel better......but sadly at 8am he crashed and they had to take him to the ICU and a few days later while I was off he passed on. Apparently the sudden drop in K+ threw his already unstable cardiac pump into arrythmias which later worsen....GO GO juice can kill ya...

Since then I have taken care a a few who have been hypoK+ from GO GO juice which induced not only diarrhea but constant vomiting.

I'm not GI expert but I have seen patients take 1/2 of golytely without results, but continued to drink and eventually results occurred. So if the patient is tolerating it without vomiting or extreme discomfort and it hasn't been that long, I would continue to give it. Patients vary in their response to how long it takes.

I have had one patient take a bottle of golytely without results, so it can happen.

Definately call the doc if you don't get results. The patient might need digital disimpaction, enemas, or have an obstruction that didn't show on the flat plate because of the high content of stool.

Keep in touch.

but had a young lady in clinical who had been given 1/2 gallon (or 1 gallon according to docs) with no result. hx of Hirschsprungs hx of colon resection. Turned out she had a massive bowel obstruction, altho' seemed uncertain because she was scheduled for surgery and then had several large BMs. For awhile they thought it was remnants of barium. They finally took her to surgery and the surgeons decompressed the small bowel of somewhere between 1-2 liters of fluid, then performed the adhesiolysis.

NurseFirst