CCS strategy

8/14/2014 11:22:13 PM
Hello,

Can anyone tell me please when we should NPO the patient and give bed rest?
eg: why in pericaditis the pt should be NPO but not in septic arthritis?

Thanks!


8/15/2014 9:11:34 AM
PaPa61518864 wrote:
Hello,

Can anyone tell me please when we should NPO the patient and give bed rest?
eg: why in pericaditis the pt should be NPO but not in septic arthritis?

Thanks!


Hey!

According to my understanding, anyone admitted to the in patient unit/ ICU/ scheduled for surgery should be made NPO as long as they are receiving fluids. NPO also usually ordered so the pt can't eat (this would work in cases of dementia or AMS when there are aspiration precautions.) I think its safe to say if the patient is unstable and admitted, we should NPO them. Once they are stable "doing bettter" and VS stable, switch to regular diet or diet specific orders. Bedrest, if they can move around and stable give them BRP. if unstable, do not give BRB, and just add monitor urine output especially if they are getting fluids. if you are unsure, don't order it.

-hope this helps a little?


8/15/2014 12:22:17 PM
NaPa51556153 wrote:
PaPa61518864 wrote:
Hello,

Can anyone tell me please when we should NPO the patient and give bed rest?
eg: why in pericaditis the pt should be NPO but not in septic arthritis?

Thanks!


Hey!

According to my understanding, anyone admitted to the in patient unit/ ICU/ scheduled for surgery should be made NPO as long as they are receiving fluids. NPO also usually ordered so the pt can't eat (this would work in cases of dementia or AMS when there are aspiration precautions.) I think its safe to say if the patient is unstable and admitted, we should NPO them. Once they are stable "doing bettter" and VS stable, switch to regular diet or diet specific orders. Bedrest, if they can move around and stable give them BRP. if unstable, do not give BRB, and just add monitor urine output especially if they are getting fluids. if you are unsure, don't order it.

-hope this helps a little?





Hello,

Thank you for your comment. It was very helpful.
I was confused why pericarditis case was on regular diet and ambulate at will But septic arthritis case was NPO!!
Do we need to NPO the pt prior to arthrocentesis? Do we need to sedate the pt prior to arthrocentesis?!

Also do we order ICF prior to any procedure such as arthrocentesis or pericardiocentesis or we asume the consent has been taken care of?


Thanks a lot!
edited by on 8/15/2014
edited by on 8/15/2014


8/15/2014 6:15:31 PM
PaPa61518864 wrote:
NaPa51556153 wrote:
PaPa61518864 wrote:
Hello,

Can anyone tell me please when we should NPO the patient and give bed rest?
eg: why in pericaditis the pt should be NPO but not in septic arthritis?

Thanks!


Hey!

According to my understanding, anyone admitted to the in patient unit/ ICU/ scheduled for surgery should be made NPO as long as they are receiving fluids. NPO also usually ordered so the pt can't eat (this would work in cases of dementia or AMS when there are aspiration precautions.) I think its safe to say if the patient is unstable and admitted, we should NPO them. Once they are stable "doing bettter" and VS stable, switch to regular diet or diet specific orders. Bedrest, if they can move around and stable give them BRP. if unstable, do not give BRB, and just add monitor urine output especially if they are getting fluids. if you are unsure, don't order it.

-hope this helps a little?





Hello,

Thank you for your comment. It was very helpful.
I was confused why pericarditis case was on regular diet and ambulate at will But septic arthritis case was NPO!!
Do we need to NPO the pt prior to arthrocentesis? Do we need to sedate the pt prior to arthrocentesis?!

Also do we order ICF prior to any procedure such as arthrocentesis or pericardiocentesis or we asume the consent has been taken care of?



Thanks a lot!
edited by on 8/15/2014
edited by on 8/15/2014


Soooo, I re-read the explaination. It seems when we are going to admit someone and "further evaluate" them, the pt should be placed NPO, because we may be ordering a "procedure" and my logic is that we are preventing complications in case the patient needs to be scheduled for surgery. We won't know if we are going to be doing a surgical procedure right away, because we have to "further evaluate" them. The patient for septic arthritis was already given morphine 1x for the pain. I am not too exactly sure what the arthroscopy results said, but usually the impression results say something like "the patient was prepped with blah blah blah and after sterile procedure blah blah blah". I am not sure what you mean by ICF, but i am assuming you mean informed consent. In my experience, if you order something, "the patient will hope the rx resolves their problem" or the pt will deny the procedure. I guess it's safe to assume they will agree if you do everything right. I always rx the CCS pts like they are real, and i counsel/reassure and think "ok, did i order everything?" is this pt set for the procedure? you just have to be wise with time management and try your best with all you remember.

hope this helps.


8/15/2014 6:44:04 PM
NaPa51556153 wrote:
PaPa61518864 wrote:
NaPa51556153 wrote:
PaPa61518864 wrote:
Hello,

Can anyone tell me please when we should NPO the patient and give bed rest?
eg: why in pericaditis the pt should be NPO but not in septic arthritis?

Thanks!


Hey!

According to my understanding, anyone admitted to the in patient unit/ ICU/ scheduled for surgery should be made NPO as long as they are receiving fluids. NPO also usually ordered so the pt can't eat (this would work in cases of dementia or AMS when there are aspiration precautions.) I think its safe to say if the patient is unstable and admitted, we should NPO them. Once they are stable "doing bettter" and VS stable, switch to regular diet or diet specific orders. Bedrest, if they can move around and stable give them BRP. if unstable, do not give BRB, and just add monitor urine output especially if they are getting fluids. if you are unsure, don't order it.

-hope this helps a little?





Hello,

Thank you for your comment. It was very helpful.
I was confused why pericarditis case was on regular diet and ambulate at will But septic arthritis case was NPO!!
Do we need to NPO the pt prior to arthrocentesis? Do we need to sedate the pt prior to arthrocentesis?!

Also do we order ICF prior to any procedure such as arthrocentesis or pericardiocentesis or we asume the consent has been taken care of?



Thanks a lot!
edited by on 8/15/2014
edited by on 8/15/2014


Soooo, I re-read the explaination. It seems when we are going to admit someone and "further evaluate" them, the pt should be placed NPO, because we may be ordering a "procedure" and my logic is that we are preventing complications in case the patient needs to be scheduled for surgery. We won't know if we are going to be doing a surgical procedure right away, because we have to "further evaluate" them. The patient for septic arthritis was already given morphine 1x for the pain. I am not too exactly sure what the arthroscopy results said, but usually the impression results say something like "the patient was prepped with blah blah blah and after sterile procedure blah blah blah". I am not sure what you mean by ICF, but i am assuming you mean informed consent. In my experience, if you order something, "the patient will hope the rx resolves their problem" or the pt will deny the procedure. I guess it's safe to assume they will agree if you do everything right. I always rx the CCS pts like they are real, and i counsel/reassure and think "ok, did i order everything?" is this pt set for the procedure? you just have to be wise with time management and try your best with all you remember.

hope this helps.




Thank you so MUCH for the helpful and detailed explanation!
All the best.


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