Chapter 21 - Nonparenteral Medications Flashcards
What are some contraindications to receiving oral medication?
-NPO status
-N&V
-bowel inflammation
-reduced peristalsis
-recent GI surgery
-gastric suction
-decreased LOC
Sublingual medications act in ____ mins
15
Most oral medications act in __-__ mins
30-60
What do you do is an adverse effect occurs?
-notify HCP and pharmacy immediately
-withhold further doses
-assess vital signs
-add allergy information to medical record
What do you do if a patient refuses a drug?
-assess why they are refusing
-provide further instruction
-do not force
-notify HCP
Where do you record a patients response to medication?
nurses notes
What do you educate patients about for medication?
-purspose
-action
-dose
-dosage interval
-side effects
-foods to avoid or take
-what to do if missed dose or ae occurs
Never administer medications into a NG tube inserted for _____________
decompression
What medications can you not crush?
-sublingual
-sustained-release
-chewable
-long-acting
-enteric-coated
What are contraindications of enteral medications?
-bowel inflammation
-reduced peristalsis
-recent GI surgery
-gastric suction that can’t be turned off
What is important to asses about absorption when giving meds through feeding tube?
is the point of absorption bypassed by the feeding tube?
If medication interacts with enteral feedings stop feeding at least ____ mins before admin
20
How much tepid water do you use for enteral med admin?
50-100mL
What is tepid water? Why do we use it?
lukewarm; prevents abdominal cramping that can occur with cold water
Use _______ water for critically ill or immunocompromised patients
sterile
If you have to crush tablets and give enterally what should you do first?
flush the tubing before and after and dilute the medication
How much water do you dissolve a tablet into for enteral admin?
30mL
What should asses before administering enteral meds?
-auscultate for bowel sound
-verify placement of feeding tube by observing gastric contents and checking pH
What is a good gastric pH?
<5.0
How do you check for gastric residual volume?
draw up 10-30mL of air into a 60mL syringe and connect syringe to tube, flush tube with air and pull back slowly to aspirate gastric contents, return contents to stomach after measuring
If GRV exceeds _____ ML, hold meds and contact HCP
250
If administering more than one dose enterally…
flush in between with 15 to 30 mL of water
Follow the last dose of medication with ____ to ___ ML of water
30-60
What do you do if a patient shows signs of aspiration during enteral feeding?
-stop medications
-elevate head of bed and stay with patient
-assess vitals while another HCP notifies dr
