NPO except meds?

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I had a diabetic patient who was scheduled late in the day for a lap chole (430-5pm) due to getting dialysis first. His orders said "NPO except meds" so I was giving him his BP meds all day, with the latest at 3:30. His sugar started to drop so I had him drink cranberry juice with his pills and we switched his IVF to dextrose, but the OR came to get the patient over an hour early. So PACU got mad when the patient told them he had cranberry juice and I completely forgot to tell them he had his po meds. Now I feel dumb? 

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That means he can take his meds with a sip of plain water, not juice. That could've pushed back his surgery time and NPO requirements, depending on anesthesia rules in your facility. You can't unring this bell, but will know for future cases.

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Don't beat yourself up. First if all, who schedules a diabetic for OR late in the day! The nurse is left to manage the blood sugar all day. I would have just given the meds with small sips of water .. but what WAS the blood sugar? Was it 10% dextrose? 

You did not need to report you gave po meds, they can see the pre-op orders.

 

 

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Specializes in ER.

I never understood how NPO except for meds accomplishes the goal of NPO before surgery. You may as well say 'NPO except for a cookie' in my opinion. 

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Specializes in retired LTC.

How about 'NY cheesecake' piece?  :)

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Specializes in Public Health, TB.

I think some surgeons are just too lazy to take a look at the med list and decide what is essential before surgery and what can wait. For instance, nutritional supplements can likely be held, as well as anticoagulants and metformin. And then there are instances like my husband's oral surgeon, who used an old med list, and gave him directions to hold meds he was no longer on.

 

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Specializes in Infusion Nursing, Home Health Infusion.
On 11/12/2021 at 2:33 AM, Emergent said:

I never understood how NPO except for meds accomplishes the goal of NPO before surgery. You may as well say 'NPO except for a cookie' in my opinion. 

I'm sure you know the answer! It's NPO except for meds with just enough water to get it down if you have an order.They add on several more hours than it actually takes a human stomach to empty.Also it would  take longer for a cookie to empty than a few pills and a sip of water. 

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Specializes in ER.

So, if you we're on a desert island and had to be NPO except for one food, what would it be???

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Specializes in Infusion Nursing, Home Health Infusion.

I would want a bowl of baked macaroni.It must be home tomatoe sauce too. 

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