Npo

[Sue McGann]

I have a question that I thought was a no brainer.

At the hospital where I work they are questioning what NPO means. I think it means what it says. Nothing by mouth, NG tube, G tube or any other feeding device. Some people are suggesting that it does not include medications. Meaning if a patient is NPO you can go ahead and give medications with sips of water without a physicians order. I have never hear of this. So I would like to know what your experience is where you work. Please let me know what state you live in. thanks Sue

[Marie_LPN, RN, LPN, RN]

If someone is NPO (nothing by mouth) there is a bright sign above their bed and a blank space below "NPO" that the nurse write in black marker "except meds" or "icechips" after reading the Dr.'s order.

[santhony44, MSN, RN, NP]

NPO has always meant nothing! Unless, as others have said, there is a specific order. If there is a concern about particular meds, then clarify the order with the doc.

[Noney]

If there is a specific order for NPO then you don't give anything.

But if the NPO is in standing orders for a procedure, I use my judgement.

For example if the pt is NPO for a haert cath at 0900 and iti s 0400 and they need something for pain I will give a pain pill with a sip. It depends on the facility, the reason they're NPO, and the md.

I would not tell someone else to give a med to a pt that is NPO if they are not comfortable with it. I would tell them to call the md if they are not sure what to do.

We just need to use our critical thinking skills sometime.

Noney

[SmilingBluEyes]

NPO means just that NOTHING BY MOUTH, to include meds, ice chips, anything swallowed. That has been true at least everywhere I have worked.

[kids]

In the area I have always practiced (SW WA) NPO means nothing by MOUTH. If the patient is to have nothing via NG/GT then a seperate order is needed specifying nothing per tube.

[MidniteLaborRN]

it is the same where i work--npo means nothing by mouth. exceptions are written as orders.

[Nursekatydid]

NPO at our hospital means NPO. A doctor has to write except for meds if they are to get meds by mouth. Now I am confused when you said down NGs and g-tubes, b/c NPO means nothing by MOUTH. Could you clarify please? thanks

[NICU_Nurse, BSN, RN]

NPO technically means nothing by mouth; patients are typically made NPO prior to surgery because of the risk of them vomiting due to the anesthesia and the possibility of aspirating on the table or shortly afterwards, while they are recovering from the anesthesia. Generally, NPO prior to surgery means the doctor doesn't want anything in the stomach. NPO can also be used for people who aren't tolerating their feeds for whatever physical reason, etc. Some patients have oral or esophogeal problems that require them to be NPO, meaning nothing should be traveling through the mouth or down the *throat* to get to the stomach, either (ie, varices, oral lesions, etc.). Some are NPO because they are vomiting due to an illness and in these cases, the doctor is usually providing alternate nutrition to spare them the discomfort (and the electrolyte imbalances, not to mention the oral blisters, etc.) of having to eat and then having it all come back up again. And still others are allowed to receive only medications, which are typically very small amounts (ie, small ml increments) and will be digested before surgery takes place, or are so small in measurement that they would be negligible should they vomit after taking them. Basically, you have to consider what's happening with the patient to determine exactly WHY they are NPO, and hopefully, the MD has (or is willing) written this down for you with the specifications that pertain to that particular patient. Otherwise, call them and clarify, as others have mentioned doing.

[majrn]

Well put NICU_Nurse!

[stella123 rn]

Often times we have a patient who is NPO before surgery and the doc will write may have zestril etc... with sips of water. Even just an hour before surgery. Our doctor's are good ar writing specifics.

[ceecel.dee, MSN, RN]

Originally posted by Noney

If there is a specific order for NPO then you don't give anything.

But if the NPO is in standing orders for a procedure, I use my judgement.

For example if the pt is NPO for a haert cath at 0900 and iti s 0400 and they need something for pain I will give a pain pill with a sip. It depends on the facility, the reason they're NPO, and the md.

I would not tell someone else to give a med to a pt that is NPO if they are not comfortable with it. I would tell them to call the md if they are not sure what to do.

We just need to use our critical thinking skills sometime.

Noney

I agree with this. Pre-ops are to take heart and BP meds with small sip of water, pre-stress tests are to take only certian heart pills, etc. These aren't necessarily written. It is the school of "hard knocks" that tells us.

[jenac]

I'm in Ohio. At the LTC where I work- NPO includes meds, except when specificly ordered otherwise by the Dr. We have had lots of people NPO for procedures who were allowed specific heart meds only with a sip of water, but this is always an order. Without one- they get absolutley nothing by mouth.