Chapter 6: Non Parenteral Medication Administration
6.3 Administering Medications by Mouth and Gastric Tube
Critical Thinking Exercises: Questions, Answers, and Sources / References
- Your patient is dysphagic. Discuss the steps you should take and the considerations you should be cognizant of to administer oral medication safely.
Answer: have the patient sitting upright to reduce risk of aspiration. Consult speech language pathologist for swallow assessment. Thickened fluids might be necessary. Remain with patient while they take their meds to assist if choking should occur. Ask the patient if you can crush each med and put it into food / jam / pudding for easier consumption.
2. Your patient is unable to swallow and is receiving medication and nutritional sustenance via an enteral jujenostomy tube. The drug reference guide recommends that their medication should be given on an empty stomach. Discuss how you would approach this situation.
Answer: stop the tube feed for 30 minutes prior. Check placement of J tube by measuring external length. If concerns with migration (in or out) consult prescriber prior to administering medications. If placement satisfactory, flush with warm water 30 ml, before and after and 15 ml in between meds. Each med to be administered separately to reduce risk of tube blockage dilute each med with 15 ml water; if it is necessary to crush pills, make sure pills can be crushed (no LA ,SR, CR, enteric coated) and dilute with 15 ml water. Do not resume tube feed until 40 minutes afterward.
Source: Perry, A., Potter, P., & Ostendorf, W. (2017). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.
