Npo

MandyInMS · Aug 30, 2003

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

Same here :)

boggle, ASN, RN · Aug 30, 2003

I agree tht we nurses often have the judgement to know when it would be OK to give oral meds when there is an NPO order,....

but.... for most of us, that is really beyond our scope of practice.

I know the docs I work with, And know what they usually order, And know they meant to write that order to give the oral meds. And I hate to bug them on the phone for the verbal order. Still, it's not worth putting my license on the line because of their inattention to writing complete orders when they order NPO.

NPO means NPO. There must be orders (or standing orders) to give oral meds.

I'm getting pretty tired in general of phoning to get complete orders that should have been written when the doc was in. I have enough of my own work to do.

Brownms46 · Aug 30, 2003

I agree boggle! If something happens, whether it had anything to do with giving the med or not, some lawyer will use that against you. I would prefer not to have to explain why I gave that med with an order stating just NPO. But then that's just me:)

MandyInMS · Aug 30, 2003

I agree boogle..if there is a SPECIFIC order written NPO..that means NOTHING by mouth...but is a little diff to me if pt is "on hold" for labs,xrays,procedures. Say pt is on hold for am labwork which is drawn about 7-8 am..protocol is on hold after midnight..at 2 am pt needs a prn for headache..I'd give the prn with a sip of water.Wouldn't affect the test and the MD hadn't written an NPO order.I think that's what Noney was tryin to say.

nowplayingEDRN · Aug 30, 2003

Where ever I have worked....NPO meant just that and if there were critical med, the order had to be written by the doc stating meds with sips or NOP except ice chips....if you needed to put it in their mouth or down the NGT, there had better be a Dr order for it even though we, as nurses are capable of determining which meds should still me given with a sip even though the pt is NPO.

ratchit · Sep 1, 2003

What should and should not be given should be specified by the doctor. But we all know they don't think the way we do.

NPO means nothing by mouth- ie, keep the stomach empty. No meds, no jello, no tube feeds, nothing.

But often the docs write NPO when they SHOULD write NPO except meds with sips. I don't want to give a med with a sip when the doc didn't want it given, but I don't want to withhold pain meds or send someone off to a cardiac cath with a BP of 210/100 because they didn't get their BP meds, either.

Same as with PRN meds- the docs are required to write a reason for the med- headache, fever, pain, whatever. But they don't. In both cases it's MD responsibility but the nurse who takes a risk by trying to figure out what the doc meant, and the patient who may suffer by not getting meds they needed.

If the doctor's order isn't clear, the doctor should get a phone call asking for clarification. Enough phone calls, with support from management and pharmacy requiring complete orders, and they can be trained. Really. (OK, most of them!)

live4today, RN · Sep 1, 2003

NPO...nothing by mouth!

And that settles it for all!

However...:chair:...if you can get the food or med or liquids in the patient through other orifices......... :lol2: