NPO and meds

[stephlucasrn2008]

This migt be dumb question but I am confused (and not to mention, I've had 13 preceptors in the last 2 months)...

If a patient is NPO and has an OG, NG, g-tube, etc. and has meds that are to be given throught it, should you hold them.

I had 2 patients today, one going for a HIDA and one scheduled for a TEE. I do understand the rationale to be NPO, but with OG's and NG's would this still be a concern in regards to the tests. How about if a patient is just admitted and is not yet receiving tube feedings and is ordered NPO, I have been giving them their PO meds via OG's or NG's.

I am a bit confused.

And clarifying with the physician didn't help either...

[crazymomagain1]

:nurse:Ok, here's the way I have been taught and now practice (going on 10 years now.) I perform Moderate Sedation daily on folks having TEEs, cardiac caths, CV, PPM insertions and a few other events requiring the pt to be NPO. I have also worked Trauma ICU. We request the patient to stay NPO until after the test, regardless of NGT or FFT. We insert a camera into the Esophagus to look at the heart. If there is anything in the stomach, it may come up when we insert the tube and hit the gag reflex. A big risk for aspiration! And a mess I don't care to want to clean up. So, you did right. When in doubt, ask. I was once a preceptor and enjoyed questions verses assumptions. Good luck!

CV RN

[Southern_RN]

Just clarify if it is a "Strict NPO" or "NPO except meds". Every MD is different, and contradictary to the previous answer posted, we request our procedure pts to recieve their usual meds (with the exception of glycemics and diuretics) with no more than 8oz of water.

Just another perspective

[Creamsoda, ASN, RN]

On our unit ICU, NPO means we are not feeding them, but usually they have many oral meds ordered, so yes we give them their meds by NG but thats it. Obviously your gonna give as little fluid when mixing them up as well. Enough to disolve the meds, and a flush.

If they are strict NPO, then nothing, unless specifically ordered by the doc. If they had oral meds, then I would double check. Most of our patients are NPO the first day or so, then we start tubefeeding assuming theres no contraindication for doing so, or they need TPN.

[sicushells, RN]

Often you should look at a)what procedure they are or have had that is causing them to be npo. b) what meds are ordered. If you're supposed to give docusate fo a patient who's bowel prepped and going for a EGD... you should probably hold it. If you're giving psych meds or amiodarone(etc.etc.) to a patient going for a pacemaker placement in six hours... it's probably okay.

Like everything in nursing there's no hard and fast rule, it depends on the patient, the patient's condition, and the situation. Yeay for nursing judgement! (And we're "only" nurses:yeah:)

[Nurse Lulu]

I always look at what the meds are- i.e. if it is colace it can wait. If it is seizure med, cardiac, etc I clarify CAT

[Reno1978, BSN, RN]

If there's any doubt in your mind about whether or not you should be doing something, ask. I think the best answer to your questions is that it just depends on the patient.

Sometimes if the MD isn't helpful in clarifying if the NPO order should include meds, calling to the department that performs the test may be more helpful.