Newbie RN, ? about Lopez valve

[gospa]

Hi all,

I'm in my first week as a new RN on a medsurg floor. I only came across a Lopez valve two or three times in clinicals over two years. Now that I'll be seeing them much more often, I'm wanting to become more adept with them. I've googled their use and can never find a set of instructions; the websites I find are always down, and my nursing skills book doesn't address the valve.

Let's say the Lopez is on an NG tube. The off arrow points at the med/flush port.That means I can't give meds if memory serves me, correct? If I turn the off arrow toward the patient and the NG tube, then does that mean nothing can come out of the pt or nothing can come in to the pt? Likewise, if I turn the arrow toward the wall suction (the 3 o'clock position)?

And if I want to give meds to the pt, which direction do I turn the arrow? If I give meds, I don't have to disconnect anything, right, because the Lopez is used for just this purpose, but I DO have to turn off suction? Thanks for any help. There are sooo many things to know and remember!! :)

[nurseprnRN, BSN, RN]

Why would you be giving any meds down an NG tube that is (or will shortly be) hooked up to suction? Why not just shoot 'em into the cannister and eliminate the middleman?

That part needs clarification. :)

[lefrench123]

You will definitely have to turn off the suction when giving meds for at least 30 minutes (some will tell you an hour). Remember that anywhere the arrows on the lopez valve point are open, and anywhere the off section goes to is closed. So, if you want to flush or give meds, keep the off pointed at the red cap, take off the red cap, and hook up your syringe to that port. Then you flip the off section away from the patient (towards suction), so that the arrows are pointed towards your syringe and towards the patient. These areas are open and you can flush/give meds to the patient. Before you remove the syringe, point your off arrow back towards that direction. You learn which way the arrows go after a couple tries when you make a mess (at least I did).

[eager1hasbegun]

Congratulations on the new job! Just want to stress to you that while you are orienting, to take advantage of all the help you can. You have a preceptor, right? You should be asking him or her ALL your questions. Don't be afraid to ask too many. Often we might be concerned when new people AREN'T asking questions. And ask different people, so you'll know who to talk to about trach care and who not to ask about wound care, etc. Also, hopefully your coworkers should be able to point you to a resource the facility uses. My hospital had a link to a skills website that had a database of nursings skills and procedures listed step by step, because even when your a seasoned nurse, you'll come across something you haven't seen before, or haven't seen in a year.

[SimayRN]

The way I remembered it when I was a new grad was the arrows are a road. If the arrows continue in a straight line then fluid, meds, or tube feeding can cross through "the road" but if I want to stop movement to the patient put the non arrow part closest to the patient.

[jdakay]

my vn students are now quite adept with this creature. ngt/gt/jt patients are my specialty in clinical rotation with my vocational nursing students. at first they were scared on how to deal with it because they don't know which tube is closed or opened. I let them figure it out because it is just a matter of knowing your directions instead of the instructor telling them what to do every time they see a lopez valve attached to a gtube. It's the instructor who will learn more and not the students if theyre too dependent. Also with enteral med pass, one must be ambidextrous that you are able to use both hands when checking for placement, residual, flushing and giving meds or bolus feeding without any help from the nurse's aide.

Well good luck in knowing how to work with the Lopez Valve. At times, you can learn it by Trial and Error.

[JKL33]

Oh yay. I just PM'd somebody about a 5 year old topic. I bet they learned how to use a lopez valve by now.

[_firefly, BSN, RN, EMT-B]

In my somewhat brief experience, if a pt is on suction via ng tube, they are also npo including oral meds. But lets say it is a kangaroo pump. Then, pause the pump, flush, tutn the valve a quarter turn so the hopefully capped syringe port is open which will be obvious as you try to flush. If you get it wrong things come back out at you and then you learn. Very little harm. That said, manufacturers of things tend to have education material online.