Old Wives Tale or Nursing Intervention?

[mappers]

I was just off orientation and was getting report from a more seasoned nurse. The patient was constipated and she offered him prune juice and a light bulb went off. Why didn't I think of that? What a smart idea? Instead of calling the Dr. for an enema or senokots, why not offer prune juice?

What other old-timey remedies do you use as a nursing intervention? I'd love to learn more. The other day I tried offering milk to a patient for some indigestion. The only med I had was phenergan which I thought was a bit much for indigestion. The patient liked the idea and it seemed to work. (Within her diet, etc.)

I know we often use hot coffee and warm prune juice for constipation, as well as good old fashion walking around. What else is out there? For my kids, my goto remedy is an ice pack, but in the hospital, I know we can't always use ice or heat without an order.

I'm thinking LTC nurses have a ton of these. Am I wrong? I'd love to learn more stuff.

[kat7ap]

For a postpartum patient who can't pee - blow bubbles through a straw into a cup of water.

Peppermint tea for gas pains.

A "brown cow" for constipation - MOM and prune juice mixed and heated up together - yummy!

[Not_A_Hat_Person, RN]

I was taught in school that ginger ale can unclog a feeding tube.

[Indy, LPN, LVN]

Any carbonated soda can unclog a feeding tube, you just have to do it right. If you have a 3way stopcock (lopez valve), take it off and get a new, clean one. Or take the old one, use a coffee stir thing (plastic) and ream it out, then soak it in warm water. If that was not the problem, get your 60cc cath syringe, dip in cup of freshly opened soda, pull back halfway. You should get some coke, a few bubbles. Attach to feed tube, pull back the rest of the way and hold it. clamp tube if it has one, unattach syringe and dump contents in sink, rinse out syringe, and repeat. Of course put a towel down where you keep working because it gets messy.

If at any time you pull back small chunks of stuff, put warm water in the syringe next and try to flush it. What happens is this, you pull enough of the gunk back to allow some soda to seep in and start working on the impacted stuff. Continued pressure pulls back more gunk, letting the soda in a little more each time. Between that and honest attempts to flush you work the clog a little at a time till it loosens up. This also works with NG tubes used as feed tubes but sadly it doesn't work much at all with a dobhoff tube, unless the clog is in the first few inches of the tube. Dobhoffs tend to get the gunk deep in near where they empty in the stomach, then the lumen flattens when you try good suction.

By the way, the pressure element of this can be used to unclog a freshly clotted picc line, but I haven't tried it on a central line NOR a peripheral INT. (NO SODA.) Take a 10cc syringe, either empty or with 5cc saline in it. Attach securely to clogged luer lock. Unclamp port and pull back all the way even if you get nothing. Clamp, unattach while still pulling back on the syringe (a little tricky). Then either draw 5cc saline up, or if you had 5cc in there to begin with, get rid of the air. Reattach to port, unclamp port and then, push it like you mean it. It usually works and then you can heparinize it. Piccs are sturdy so they can usually handle this if it has become clogged on your shift, like within a few hours. Don't try if it's been longer than that, you may not know your strength and trying to explain surgical removal of the end of a picc line is not something anyone wants to do. This technique also probably will not restore blood return to a picc lumen but it will let you continue your infusions.

[cherrybreeze, ADN, RN]

I concur with several mentioned; warm packs to the abdomen are great for gas pains, cool washcloths to the forehead are great for nausea (you can also place them on the the back of the neck, esp if the patient is sitting up...sometimes they'll get dizzy/nauseated when first getting up to walk post op, so if they sit in a chair or on the toilet and feel punky, put the washcloth on the back of the neck, great relief!), prune juice, the running water to pee. Depends on the person, some like it on full blast, some like a little trickle. :) Putting their hand under warm water can help, too.

Another great headache remedy can be caffeine, once they are cleared for liquids....often, since they've been NPO all day long (and sometimes a day or two), that headache is caused by caffeine withdrawal. A cup of coffee or soda can be all they need. My sis taught me the trick of soaking your feet in cool water to help a headache, too...diverts the blood flow from your head to decrease the pounding, it really works!

A nurse that works in our PACU will sometimes put some lavender oil/extract on a piece of gauze, and put it by the pillow of a patient that's restless (as long as they don't have an aversion to the smell, and it doesn't make them sick to their stomach). It can be VERY calming. Peppermint oil can do the same for nausea. A drop or two of peppermint oil in to the toilet bowl can help someone void who's having trouble (wish I could remember why, but I don't!). The menthol fumes help everything relax, I believe. If you have a specipan in there, you could drop it in there, too, but otherwise straight in to the water.

Those are all I can think of for now, hope they help! :) Sometimes the simplest things are the best!

[morte, LPN, LVN]

for a patient with the ability to follow direction.....if they appear to be coughing d/t choking on something or inhaling something.....but obviously have patent air way, try to get them to inhale through their nose and exhale through their mouth.....the instinct is to breath in through the mouth.....which just takes back whatever they coughed up.......

[HmarieD]

By the way, the pressure element of this can be used to unclog a freshly clotted picc line, but I haven't tried it on a central line NOR a peripheral INT. (NO SODA.) Take a 10cc syringe, either empty or with 5cc saline in it. Attach securely to clogged luer lock. Unclamp port and pull back all the way even if you get nothing. Clamp, unattach while still pulling back on the syringe (a little tricky). Then either draw 5cc saline up, or if you had 5cc in there to begin with, get rid of the air. Reattach to port, unclamp port and then, push it like you mean it. It usually works and then you can heparinize it. Piccs are sturdy so they can usually handle this if it has become clogged on your shift, like within a few hours. Don't try if it's been longer than that, you may not know your strength and trying to explain surgical removal of the end of a picc line is not something anyone wants to do. This technique also probably will not restore blood return to a picc lumen but it will let you continue your infusions.

I don't think I would try this. Sounds like a good way to turn a clotted PICC into an embolus to me. Never force a flush.

Another variation on the prune juice cocktail - the "brown bomber" - equal parts prune juice, orange juice, and lemon-lime soda. Works like a charm!

What about MOM on the skin surrounding a colostomy stoma, either to prevent excoriation or treat it.

[Indy, LPN, LVN]

We don't have MOM as floor stock, it's per orders. A lot of the ostomy patients don't seem to have MOM on their prn orders, so between that and readily available ostomy glue, powder, and skin prep I haven't tried MOM on the skin. Will keep it in mind, though.

And the picc technique I described is for a freshly clogged picc, one that you know worked a few hours ago. They can be fickle and if I got a decent flush for a midnight antibiotic, then it sticks on me at 0500 I may try this. There is a difference, even if only a slight one, in how the thing feels when you try to flush a fresh clog versus one that has sat there for a longer time. So it's difficult to tell you what it feels like. One example would be that the amount of strength for the end flush is less than the amount required to push D50. I hope that helps.

[jrsmrs]

In school we have been taught to run water nearby to help someone pee. But also that the old practice of pop to unclog a feeding tube actually causes more trouble in the long run... the sticky sugar in the pop actually causes more clogs. We simply flush before and after feeds with warm water.

[JoJo626]

For nausea, any ginger product will work. I am fond of ginger snap cookies (can't stand ginger ale).

A PA I worked with would tell his patients to mix mineral oil and peach nectar and drink it for constipation. From their comments at their next visit, it works pretty good.

[Spidey's mom, ADN, BSN, RN]

It has to be real ginger in my experience . . . not artificially flavored.

I have some tea at home called "Organic Ginger Aid" by Traditional Medicinals. (Promotes healthy digestion*). It is an herbal tea, no caffeine. It says it promotes the flow of digestive juices and increases tone in the muscular walls of the stomach . . . . used for indigestion and clinical data supports its use for the prevention of nausea and vomiting . . "

I also buy the real ginger soda for home use.

steph

[meluhn]

Great idea for a thread...

How about using soda to unclog a feeding tube

I never tried this and I dont see why it would work. I found the best way to unclog a feeding tube is to milk it while holding it at the base and using a lubricant like liquid soap to milk it with your other hand. Stuff comes out like toothpaste. Then flush with warm tap h2o.

[meluhn]

What about MOM on the skin surrounding a colostomy stoma, either to prevent excoriation or treat it.

I have never heard of this one but I have herd of putting mylanta around an excoriated gtube site. The rationale is that the acid leaking out around the tube can be neutralized by it and so it doesn't harm teh skin.