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Discussion

NPO after midnight

Hello guys,

I have a question to ask. I had a patient that was going to have a procedure done (I'm not going to name the procedure to avoid hippa). Anyways it not a surgery or anything just scanning. The physician gave order for NPO. However, this patient has elevated WBC and had IV antibiotics order. I checked with my preceptor prior to see if it is ok to give it. I am pretty sure you can still give IV meds when the patient is NPO. My preceptor told me the same. I gave the patient her IVPB antibiotics, and her methylprednisolone IV push. THe question is you can still give IV meds if the order is to be NPO?

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    • Featured Replies

    NPO only means nothing orally. Since IV meds are not swallowed there is no reason not to give them if not contraindicated. This is the same as patients with NPO diet orders on TPN. They are getting nutrients, just not orally.

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    Second what the above poster said. NPO means nothing by mouth. IV medication, IVF, or for,a of if nutrition are perfectly okay to administer. If a patient is going to be NPO for a while then they actually need some IVF at the very least, probably some form of IV nutrition.

    You did fine.

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    • Admin

    Pet peeve warning: It's HIPAA (Health Insurance Portability and Accountability Act) not hippa (makes me think of female hippos).

    NPO stands for Nulla Per Os, which is Latin for nothing by mouth. I honestly find it shocking that a nurse doesn't understand that NPO means nothing orally but that other methods of medication delivery are fine. Harsh, but this is basic knowledge.

    You will also find that some physicians will also write to give certain meds with a sip of water. The cardiac surgeons I work with write an order that all cardiac meds are to be given with a sip of water despite being NPO. Additionally, if you have a patient on antibiotics or other blood level pertinent drugs (such as anti-seizure drugs), there is nothing wrong with asking if they should be given with a sip of water or provided via an IV substitute during the time the patient is NPO.

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    • Author

    I know NPO means nothing by mouth Ms. Rose. I said I was pretty sure I can still give IV meds if the patient is NPO. HOwever, I'm a new hospital working in the hospital setting. I just wanted to make sure that is why I asked my preceptor before giving it, and asking for advice on here.

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    I'm with Rose I'm shocked this was a question. Of course you can still give IV medication since they aren't PO.

    We either have doctors that write patients NPO or NPO with meds (so they get a sip of water and that's it). If they are strict NPO then I call pharmacy and ensure everything we give is switched to IV, otherwise the meds get held.

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    Is it a HIPAA violation to mention a procedure done? I thought that, in order to violate HIPAA, you needed to reveal patient identifying factors, such as their name, age, address, etc.?

    Don't worry that some peoples are shocked at your question, regardless of how simple they believe it be. I couldn't care less what people think, if I have a question, even if it's the most rudimentary of questions, I will ask it, every time.

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    • Author

    I don't know Levitas. I read another thread on here where someone mention on here to not mention any procedures so I just want to be safe. You are right Levitas. It is better to be safe than sorry so it is good to ask if I'm not sure of something.

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    I would not question the route, as long as it is not PO. But I might question the meds. In this case there does not seem to be an issue, but some meds should be taken with food. Check before you administer. Insulin, for instance, might have to be held depending on the type of insulin, how long the patient will be NPO and other factors. Always best to ask! Also, know where your resources are in case something does come up that you are not sure about.

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    NPO=nothing by mouth. End of story. If they want nothing by IV, which is unheard of, that would have to be stated differently.

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