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NPO with NG tube, no IV fluids?

Posted

Specializes in Med Surg, Parish Nurse, Hospice. Has 44 years experience.

I was visiting one of my church members in the hospital yesterday. He is an elderly man 90 plus, alert and has been living at home alone. He is in the hospital for a bowel obstruction. Treatment is conservative due to his age.

I have been away from hands on bedside nursing for about 2 years. When I arrived to see him, he told me that his Blood Pressure had been up today. I noticed that he still had his ng tube to suction. He said he was thirsty and I looked to see what kind of IV fluids he had going. He didn't have any IV fluids going. The RN was in his room and I asked her, she told me that he was getting IVPB antibiotics. She also told me that she hadn't had a chance to review his chart as she had just received report on him. I said that I was his nurse from church and I was stopping by to check on him. I left shortly after that.

Is this a new thing, I know that he told me his BP was up, but I don't remember in my past 35 plus years of nursing experience having a patient NPO with a NG tube and no IV fluids of any type at even a slow rate.

Am I missing something new? I don't have access to labs, vital sign etc. only what I heard and observed.

THELIVINGWORST, ASN, RN

Specializes in Public Health. Has 4 years experience.

If you're a nurse then you know there are a myriad of reasons why he might not have fluids going.

Sorry I can't be of more help but you don't have enough info about his situation nor health history to tell whether this is appropriate or not.

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

I'd def. be asking the provider about IV fluids if NPO and not on jejunal feeds or TPN. They overlook that quite frequently in my experience.

Is he on a fluid restriction for CHF? Still though, a fluid restriction is not NO fluids.

jrbl77, RN

Specializes in Med Surg, Parish Nurse, Hospice. Has 44 years experience.

I visit this man in his home once per month and do his vitals and review his meds. I don't remember him having CHF. He really doesn't take many meds for a man of his age.

mmc51264, ADN, BSN, MSN, RN

Specializes in orthopedic; Informatics, diabetes. Has 9 years experience.

He should at least have replacement fluids for NG output (we have it ordered 1:1 or 1/2:1) I would think. I get very nervous with no fluids and NPO. Is he getting his glucose checked? real easy to go low, our NPO/NG get Q6H checks.

Jory, MSN, APRN, CNM

Has 10 years experience.

I was visiting one of my church members in the hospital yesterday. He is an elderly man 90 plus, alert and has been living at home alone. He is in the hospital for a bowel obstruction. Treatment is conservative due to his age.

I have been away from hands on bedside nursing for about 2 years. When I arrived to see him, he told me that his Blood Pressure had been up today. I noticed that he still had his ng tube to suction. He said he was thirsty and I looked to see what kind of IV fluids he had going. He didn't have any IV fluids going. The RN was in his room and I asked her, she told me that he was getting IVPB antibiotics. She also told me that she hadn't had a chance to review his chart as she had just received report on him. I said that I was his nurse from church and I was stopping by to check on him. I left shortly after that.

Is this a new thing, I know that he told me his BP was up, but I don't remember in my past 35 plus years of nursing experience having a patient NPO with a NG tube and no IV fluids of any type at even a slow rate.

Am I missing something new? I don't have access to labs, vital sign etc. only what I heard and observed.

'

In fairness, you didn't give her a chance to review anything and she may have had orders to start something. If his intake through the feeding tube is adequate, I don't see the point in an IV as it is an infection risk. There could be many reasons he was feeling thirsty, it could be his meds, mouth is dry, is he on oxygen, etc.

If the NG tube intake was adequate and managed, what would be the rationale behind the IV? What benefit would the patient gain?

blondy2061h, MSN, RN

Specializes in Oncology. Has 15 years experience.

It sounds like the NG tube was there for decompression, not feeds or hydration. I'm guessing if hes fully obstructed and they aren't planning surgery soon, he'll need TPN.

'

In fairness, you didn't give her a chance to review anything and she may have had orders to start something. If his intake through the feeding tube is adequate, I don't see the point in an IV as it is an infection risk. There could be many reasons he was feeling thirsty, it could be his meds, mouth is dry, is he on oxygen, etc.

If the NG tube intake was adequate and managed, what would be the rationale behind the IV? What benefit would the patient gain?

The OP mentioned that the NG was on suction, meaning that he was not receiving nutrition via that route.

Been there,done that, ASN, RN

Has 33 years experience.

'

In fairness, you didn't give her a chance to review anything and she may have had orders to start something. If his intake through the feeding tube is adequate, I don't see the point in an IV as it is an infection risk. There could be many reasons he was feeling thirsty, it could be his meds, mouth is dry, is he on oxygen, etc.

If the NG tube intake was adequate and managed, what would be the rationale behind the IV? What benefit would the patient gain?

You need to re- read the scenario.

There was no INTAKE from the NG tube. It was placed for decompression.Any feeding would be contraindicated with a bowel obstruction. Standard of care for bowel obstruction includes: ngt or NPO, and IV at 75 cc's /hr. Nurse did not need to review anything, that was a lame response in order to CY her A.

Edited by Been there,done that