NPO (Nothing by Mouth)

What Does NPO Mean?

NPO (nil per os) is a physician's order that prohibits a patient from receiving any food, fluids, or oral medications. CNAs must strictly follow NPO orders and understand their importance for patient safety. Violating an NPO order can cause serious complications, including aspiration during anesthesia or inaccurate test results.

Common Reasons for NPO Status

CNA Responsibilities for NPO Patients

1. Remove all food and water from the bedside (water pitcher, cups, snacks)
2. Post NPO sign at the head of the bed and on the door (per facility policy)
3. Inform dietary department so meal trays are not delivered
4. Do NOT give ice chips, candy, gum, or any oral intake unless specifically ordered
5. Provide mouth care (moisten lips with swab, assist with mouth rinse that is spit out, not swallowed)
6. Report if the patient eats or drinks anything to the nurse immediately
7. Report patient complaints of thirst or hunger to the nurse (the nurse can advocate for oral care or IV fluids)
8. Check with the nurse before giving any oral medications to an NPO patient

Important NPO Rules

• "Nothing" means NOTHING: no water, no ice chips, no gum, no hard candy, no medications by mouth (unless specifically ordered)
• Mouth care is allowed: Use moistened swabs or toothbrush with toothpaste, but the patient must spit and not swallow
• NPO after midnight is a common pre-surgical order (though some facilities now use specific hour-based fasting)
• If a patient eats or drinks while NPO: Report to the nurse immediately; the procedure may need to be rescheduled

Exam Alert

NPO = nothing by mouth (nil per os). The CNA must remove ALL food and water from the bedside, post signs, and provide mouth care (but patient must NOT swallow). If an NPO patient eats or drinks, report to the nurse immediately. Common before surgery and certain tests. Always check with the nurse before giving anything orally to an NPO patient.