#21

#21 Discuss the assessment needed when administering oral medications; medications via NG tube

1. Always check with the pharmacist to see if the clients medications come in liquid form because these are less likely to cause tube obstruction.
2. If meds do not come in liquid form, check to see if they may be crushed (enteric-coated, sustained action, buccal, and sublingual meds should never be crushed).
3. Crush a tablet into a fine powder and dissolve in at least 30ml of warm water. Cold liquids may cause client discomfort. Use only water for mixing and flushing.
4. Read medication labels carefully before opening a capsule. Open capsules and mix the contents with water only with the pharmacists advice.
5. Do not administer whole or undissolved meds because they will clog the tube.
   Assess tube placement.
6. Before giving the med, aspirate all the stomach contents and measure the residual volume. Check Agency policy if residual volume is greater than 100ml.
7. When administering the meds
   

• remove the plunger from the syringe and connect the syringe to the pinched or kinked tube. Pinching or kinking the tube prevents excess air from entering the stomach and causing distention.
• Put 15-30ml (5-10ml for children) of water into the syringe barrel to flush the tube before administering the first med. Raise or lower the barrel of the syringe to adjust the flow as needed. Pinch or clamp the tubing before all the water is instilled to avoid excess air entering the stomach.
• Pour liquid or dissolved med into syringe barrel and allow to slow by gravity into the enteral tube.
• If you re giving several meds, administer each one separately and flush with at least 15-30ml (5-10ml for children) of tap water between each med
• When you have finished administering all meds, flush with another 15-30ml (5-10ml for children) of warm water to clear the tube.
• If the tube is connected to suction, disconnect the suction and keep the tube clamped for 20-30min after giving the med to enhance absorption.

Kozier pg 811