what medication do i give when a patient is fasting?

Midwest4me · Jan 28, 2008

Is "fasting for theatre" meaning surgery?(what an interesting phrase---I like it). I'd check with the surgeon or MD; each case may be different.

Welcome to allnurses!

*naughtynurse* · Jan 28, 2008

Is "fasting for theatre" meaning surgery?(what an interesting phrase---I like it). I'd check with the surgeon or MD; each case may be different.
Welcome to allnurses!

yeah fasting for surgery. most of the time we dont have time to check with the anaesthetist or they are not avaliable. this therefore leads most of use to make the decision.

kukukajoo, LPN · Jan 28, 2008

If for surgery, then no meds that leave a residue. I remember them having to change my acid reducer pre surgery.

SDS_RN, RN · Jan 28, 2008

I worked on inpatient surg floor for last year, now work ED and rotate up to SDS. The meds we give before surg are their heart meds, GI meds & any inhalers this is per our anesthesiologist. They do not like them to have any other meds. We have a list of what meds anestitists like pts to have before surg as standing orders. Our pt's are also instructed on what meds to take preop by the doc & central reg and if they forget then we have to give them ASAP.

On inpatient surg floor we write the order as S.O. per anethesia. Hope this helps.

GrumpyRN63, ADN, RN · Jan 29, 2008

It has been my experience to give cardiac ( esp beta blockers), thyroid , GI, any scheduled or prn pain meds, antibiotics, hold on the oral hypoglycemics, lasix. Usually the anesthesiologist ill adjust as needed,or just ok continue all meds

Valanda · Jan 29, 2008

I was surprised recently when my son was going to have surgery. The MD didn't even want him to have his dilantin before surgey! MD said, "his level is a bit high anyway I don't think missing 2 or 3 doses is going to cause him any trouble." I had expected that dilantin would be one of the ones on the "give list".

GIRN · Jan 29, 2008

A lot of these answers are the same as our hospital protocol but you really should have a written protocol specific to your facility. It should be written by Anesthesia. The blood pressure, cardiac, and thyroid pills are a definite must. They can safely be taken before surgery with just a sip or two of water. Anti-convulsants are usually given as well. You'd be doing your whole floor a favor to ask your management to put all this in writing for you. We have a whole list that we use for Pre-Admission Screening. It's a breeze when they're all written out for you. Many times patient's cases are delayed and they go 10-16 hours without their cardiac or blood pressure meds because the nurses on the floor thought they had to be on strict NPO. It's important to keep them on their regular schedule as much as possible.

Nursebarebari · Jan 29, 2008

What is your hospital policy? If there is no mention of that in your policy, then you should ask tha surgeon. Sometimes they all differ on what they want, so you should ask them individually.

TiredMD · Jan 29, 2008

Typically our group gives everything except HCTZ, and if on metformin then only half the dose (published guidelines). When they're NPO, you should be careful with the insulin. Some like holding the Lovenox/heparin DVT prophylaxis. Otherwise they get everything else.

This should be clearly spelled out in the preop orders.

EmmaG, RN · Jan 30, 2008

This should be clearly spelled out in the preop orders.

Exactly. Our anesthesiologists are really good about specifying what's to be administered pre-op.

When they're NPO, you should be careful with the insulin.

Careful, yes. But insulin shouldn't be automatically withheld simply because of NPO status.

http://www.joslin.org/Files/Inpatient_Guideline_final_4-30-07.pdf

Interesting :)