NPO status

allevi · Dec 16, 2000

What about this situation? A client has a bowel obstruction, they are going to do exploratory surgery, they are NPO, to me and my instructor NPO meant NPO, but I had a med error, because this lady was NPO with po meds. Does this make sense??

I guess this was routine for the surgeon. But only being in clinical, and not working there how are we to know this? I know given this situation again, I will always ask.

Bucky · Feb 8, 2001

When I write orders for a patient to be NPO, and still want them to have certain po meds,

I'll write the order exactly that way. "NPO after [time] except may take AM meds with a sip of water." If there is any doubt, seek clarification to avoid a "med error".

There is still customary appropriateness for the NPO after midnight dictum for adult patients having first-thing-in-the-morning surgery. Such NPOness harms almost no adults.

Healthy patients who aren't terrified (terror shuts off digestion/absorption) are probably safe with NPO for 4 hours for clear liquids and 6 hours for anything else.

For children, the NPO criteria slide depending upon age. I'll abide a 2 hour NPO status for a 1 y/o, for example.

Regurgitation/aspiration is a SERIOUS situation and can result in long recovery periods, though fortunately, rarely results in death.

susanmary · Feb 9, 2001

Originally posted by allevi:
What about this situation? A client has a bowel obstruction, they are going to do exploratory surgery, they are NPO, to me and my instructor NPO meant NPO, but I had a med error, because this lady was NPO with po meds. Does this make sense??

I guess this was routine for the surgeon. But only being in clinical, and not working there how are we to know this? I know given this situation again, I will always ask.

To most MDs, NPO means no food/beverages -- some want po meds given, others don't. I'd clarify the order which should have been written "NPO except meds." Regarding NPO status, get specifics orders from the MDs regarding if any meds should be held (esp. diabetic agents, etc.) Also, what changes should be made in insulin scheduling with NPO status. There's alot of critical thinking you must do. Just document and CYA. Another point, I think it's inappropriate to give a patient with a bowel obstruction po meds --meds should be given via different routes. Anyway, learn as much as you can in clinical. The med error you made was not a biggie & you've learned something from it.

[This message has been edited by susanmary (edited February 08, 2001).]