ngt/ogt or none?

We generally notify the MD of any remaining PO meds so he can DC or change to IV. Often Zantac can be added to the TPN. Sucrose is technically not allowed for an infant that's NPO. But I'd like to meet the nurse out there that has a term kid now NPO who doesn't dip their pacifier in Sucrose! I have read (I think it was the Neo-Fax) that sucrose is effective given down an og/ng tube. I have also read (once more I think it was Neo-fax) that it would be contraindicated for NEC because it would be sugar to "feed" those intestinal bacteria.

I agree. If a baby is NPO, we change PO meds to IV or DC them. We also don't use sucrose if a baby is NPO but depending on the reason sometimes the docs ok it. For example, if a baby is NPO for suspected NEC we would never use it but if it is big fat term baby there for R/O sepsis it would probably be ok.

thanks for the immediate response.

i got confused 'coz one of our NNP ordered Reglan and Zantac P.O. for our baby who has GER. she's very much aware that the baby is having reflux, she didn't change her order to IV but instead asked my co-staff to give it via NGT.

so, my co-staff gave it via NG and didn't ask to change the NNP's order. i was shadowing this nurse the reason i have learned of this incident. is that correct action to do?

It should have been clarified, I hope you clarified the order.

my preceptor called the NNP and asked if the Zantac and Reglan should be given via NGT since babe on NPO, NNP said "give it NG."

There's no point to giving Reglan on a baby that's NPO. Zantac, yeah, I think every baby that is NPO should have Zantac but only IV. Why is the baby NPO?

From everything I have read, sucrose is useless when given down an NG, or even from a bottle. It's supposed to be absorbed by the oral mucosa to have an effect, and the only way to do that is to put it on a pacifier or gloved finger.

We won't give it to babies who are r/o NEC either, but most other NPO babies, especially term babies, are allowed to have sucrose.

We have had bad gut kids that get reglan IV, but regular old kids that are NPO don't get it. If the baby is just NPO for a procedure or a big aspirate, then we keep the PO meds, but only if it is for a short period of time.

Sucrose...NPO kids can have it, even if they have an ng to suction...whatever they swallow just comes back out. We have even put a small drop or two in intubated kids mouths....they love it and sometimes that is all they need, kind of like a chocolate fix LOL.

Most of our bad gut kids get zantac in their TPN and reglan IV when they are placed on NPO. We also use sucrose in NPO kids unless it's a bad belly. Usually use the dip the pacifier method, but some of us do use a 1/2cc in a syringe coating the mouth.