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

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Aren't we suppose to get a doctor's order for it before giving it?

Yikes! We need an order to use coca-cola to unplug a G-tube too? I'm in big trouble now.

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Specializes in ICU, CM, Geriatrics, Management.

Hey, Black. I'm calling your DNS and telling her to keep a close eye on you when she sees ya buying a Coke in the employee lounge. ;>)

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I remember when I was in nursing school years ago (not telling when!) part of our pharmacology course had a section on grains, drams, and all that neat apothocary stuff! The exam was being able to convert from drams to ounces, ounces to milliliters, grains to milligrams etc. Do they even teach that anymore? I wasn't sure as I thought some pediatric doses were still given in drams-any peds out there please feel free to correct me!

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Specializes in ICU.

Cienurse, I had to learn all that stuff, too, but I went to RN school in the 80's. I still see grains ordered occassionally, tho.

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Specializes in PACU, pre/postoperative, ortho.

I just graduated last year & was taught about grains, drams & conversion to metric.

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Specializes in Oncology.

Sodium bicarb can cause serious electrolyte imbalances... you definitely need an order and I doubt you'd get one.

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Specializes in Acute Care, Rehab, Palliative.
Sodium bicarb can cause serious electrolyte imbalances... you definitely need an order and I doubt you'd get one.

It may depend on why you are wanting it. I have a patient right now that is on bicarb tabs BID.

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he refers to me as the "duty nurse" or "nurse on duty" (I have no idea what that means)

I tell my residents all the time that I am no longer Nurse on Duty when they come to me after handover and I am charting.

Otherwise, Black, I have nothing more to add. I would get the order just to be on the safe side.

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I remember when I was in nursing school years ago (not telling when!) part of our pharmacology course had a section on grains, drams, and all that neat apothocary stuff! The exam was being able to convert from drams to ounces, ounces to milliliters, grains to milligrams etc. Do they even teach that anymore? I wasn't sure as I thought some pediatric doses were still given in drams-any peds out there please feel free to correct me!

My school taught grains to milligrams and I graduated in 2012

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Specializes in ED, LTC, SNF, Med/Surg.

You absolutely need an order to give baking soda and water. Your unit manager put their job and license on the line doing so without a doctors order, and I would report it. The only exception would possibly be if the family brought it in and gave it to the resident, but I would definitely chart that this was done so against nurse recommendation.... Nursing 101 - Cover Your Own @$$!

At any rate, does your facility not have standing/pre-printed orders? Most allow the use of tums or maalox as needed per standing order for heartburn/indigestion.

Now say the standing orders haven't been signed or your facility does not have any, then I would offer the resident milk provided they are not allergic and/or on any sort of dietary restrictions prohibiting such. Milk is high in Ca which is the primary ingredient in tums/rolaids. It works wonders for me and I have given it to several pt's with + effect. No need for a doctors order either ;-)

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So I've been researching this because I am in sticky situation. According to the FDA baking soda is a food. Its when compounded that it becomes a medication. Baking soda if considered a medicine would have to have to be labeled as a medicine. Baking soda is not even labeled as a medical food unless compounded. There is no standard or procedure just like prune juice, butter, pickles, bananas, yogurt. All of which can alter bodily function. Baking Soda is used as a tooth paste or mouth wash or on a tender tooth much like peppermint tea is used for upset stomach; no order needed it comes from the kitchen. We would obtain an order for sodium bicarb like we get an order for Pepto Bismal. I'll keep researching

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Specializes in Gerontology, Med surg, Home Health.

Baking soda might be a foodstuff, but in Massachusetts, we're not even allowed to keep Thick-It which is nothing more than a form of corn starch on the med cart because it's to be only given by MD order....go figure. Another stupid regulation in an already over-regulated industry.

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