NPO for surgery

[AggieNurse99, BSN, RN]

Do you give routinely scheduled PO medications? I know we have to give beta blockers, so I usually give all as I would if the pt was PO. A new grad took offense when I questioned her about holding synthroid.

[loriangel14, RN]

Where I work we still give PO meds with a sip of water.You don't want a pt heading into surgery without BP meds or oral diabetic meds.

[Kay28]

On my unit, the physician must specify if the patient is NPO except for meds, NPO except for H2O, completley NPO, ect. It definetely helps clear up any questions.

[Sun0408, ASN, RN]

My facility has a policy that states NPO is just that unless they also write x meds.. If the MD wrote NPO, they get nothing from me... This policy is drilled into all staff and physicians.

[Aurora77]

We only give cardiac meds if a patient is NPO. Other meds either wait until later in the day or the next day. There's no reason a patient can't skip a day of his or her synthroid--that's one I'd hold and just not give till the next am.

[sapphire18]

I agree with the above, they should be writing "NPO except meds." I will honestly usually still give meds unless it's an excessive number of pills, or liquids, anything where it will be more than just a sip of water. Then I will clarify with the physician what he wants given, and what can be held.

[KelRN215, BSN, RN]

It depends on the med and what time the patient is going to surgery. If the patient is going to surgery at 6:30am, they would probably get their am meds when they return. If they are not going until 10 am, they would get important meds such as antiepileptics. Don't want anyone seizing on the way to the OR. Synthroid can be held- when I worked in the hospital we'd probably have held it and given it upon return from the OR and then worked it back to the typical am schedule.

[roser13, ASN, RN]

Where I work we still give PO meds with a sip of water.You don't want a pt heading into surgery without BP meds or oral diabetic meds.

I would never have my NPO patients take their oral diabetic meds. There is no intake - why should they lower their sugar?

[umcRN, BSN, RN]

As others have said, depends on the meds, and the Dr should write an order for "NPO except for meds" if they want the pt taking meds.

That being said, I was a patient recently and was waiting in pre-op when I heard quite the commotion (well not really commotion but discussion between multiple people for a while), an older man's surgery (don't know what kind) was cancelled because he had been chewing gum that morning. So I suppose it really needs to be clarified on a person by person basis

[hopefulwhoop]

Well, not all oral diabetic meds lower blood sugar...

[canned_bread]

Depends on the medication. In our practice we use our nurse-intelligence and if not sure, consult with MO. On our pre-surgery sheet where we tick the box to say when last drink/food had, we specify sip of water with meds and at what time so the information is passed through the chain to surgery. Anti-epileptics, certain diabetic meds, certain blood pressure meds etc we have to keep giving.

[K+MgSO4, BSN]

Yes and any regular pain relief that they are on Targin / oxycontin etc. Helps BP control and pain relief in PACU