I am new to the hospital I am working at and they seem to run IV fluids for 24 hrs regardless how the pt is tolerating fluids. When I get a fresh C/S, the pt is on slow pit and IV fluids. If the pt is tolerating fluids well, not nauseated or throwing up, great bowel sounds, doing exceptionally well, I cut off the fluids about mid-day and continue with liquids to full liquids...etc. When I give report to the night nurse, they seem absolutely appalled. I explain to them that they are taking fluids PO and tolerating very well ...give them the whole above scenario but I can tell they are not happy or don't agree with what I did.
Finally I asked one day shift nurse and she said that it is anasthesia's order to continue IV fluids for 24 hours. We look at the orders and I point out the part that says "discontinue IV if tolerating PO". She then points to another section that says, "keep IV access for 24 hrs" and says, "see that means keep fluids for 24 hrs." I do not agree with her translation of that order.
What is the rational for keeping fluids going for 24 hrs if they are drinking fluids fine and output if fine...perfect scenerio basically.
The entire unit practices like this so it makes me second guess what I am doing. 20 nurses vs 1.
Nothing to add, as everyone else said, you are correct in your interpretation. It's their unit culture and they are "stuck" per say in their ways. Keep doing what you are doing, there is no wrong in it. :)
I think your coworker needs some reading comprehension review. You can IV access without fluids running. I'd get some clarification from the ordering MD. I would not be happy to be tethered to an IV after delivery without good reason!
I am new to the hospital I am working at and they seem to run IV fluids for 24 hrs regardless how the pt is tolerating fluids. When I get a fresh C/S, the pt is on slow pit and IV fluids. If the pt is tolerating fluids well, not nauseated or throwing up, great bowel sounds, doing exceptionally well, I cut off the fluids about mid-day and continue with liquids to full liquids...etc. When I give report to the night nurse, they seem absolutely appalled. I explain to them that they are taking fluids PO and tolerating very well ...give them the whole above scenario but I can tell they are not happy or don't agree with what I did.
Finally I asked one day shift nurse and she said that it is anasthesia's order to continue IV fluids for 24 hours. We look at the orders and I point out the part that says "discontinue IV if tolerating PO". She then points to another section that says, "keep IV access for 24 hrs" and says, "see that means keep fluids for 24 hrs." I do not agree with her translation of that order.
What is the rational for keeping fluids going for 24 hrs if they are drinking fluids fine and output if fine...perfect scenerio basically.
The entire unit practices like this so it makes me second guess what I am doing. 20 nurses vs 1.
Don't some of these women question why they still have IV fluid running if they're drinking fine? I interpret the order the same way that you do, OP. Discontinue the IVF once the patient is tolerating PO but maintain the IV access for 24 hrs.
Wow. I'm just a nursing student and think the orders are pretty clear. D/c fluids if patient is tolerating PO.
Maintain access means just that, you don't need running fluids to maintain access, a lock should suffice. I agree that it's an ingrained habit in the staff.
I know you mention that the other nurses don't like it, but what about the unit manager?
Why doesn't the doctor just change the order to be totally specific? What does the Nurse Manager or Director say?
That 3rd post-op day can be problematic. Might be glad pt has IV access, at a minimum. Besides, pt can hang onto the IV pole her first couple of times OOB. Surely there will be no staff available to help her, despite that she might feel weak and dizzy after major surgery. And yes, CS is major surgery.
If pt lost CSF, as with a spinal anesthetic, she will need fluid to replace the lost CSF. Stave off horrible headache from low CSF level.
Specializes in POST PARTUM/NURSERY/L&D/WOMENS SERVICES.
I know different hospitals have different policies, so they can differ, but I have been an OB nurse for 10 years and for as long as I have been one, every facility I have every worked at has run fluids on a c/s for 24 hours.
You run 1 bag of Pitocin, then follow with two bags of LR..Discontinuing the Pitocin is only an option if the patient is a lady partsl delivery and is not bleeding. Not an option for a c/s.
You maintain IV access on patients for 24 hours if they had an epidural...
klone, MSN, RN
14,857 Posts
You are right; they are wrong (and ridiculous). IV access does not = IV fluids. I'm irrationally annoyed at your coworkers.