Module 9: Administration of Medication via Oral, Gastric, or Nasogastric Route

Question 1

Protecting a patient from Aspiration

Answer 1

• Determine pt’s ability to swallow
• Assess pt cough
• Determine presence of gag reflex
• Prepare oral medications in form that is easiest to swallow for pt
• Ensure pt is side-lying or upright position
• Allow pt to self administer if possible
• If pt has unilateral weakness, place medication on stronger side
• Administer one pill at a time ensuring it is swallowed before introducing the next
• Thicken regular fluids
• Have pt hold and drink from a cup if possible
• Meds should coincide with meal times or when pt is well rested and awake when possible
• If risk is severe, administer via another route

Question 2

Slower onset of action and more prolonged effect than parenteral medications

Answer 2

• Oral (PO)
• Sublingual (SL)
• Buccal

Question 3

Preparing Liquid Medications

Answer 3

1. Gently shake container
2. If multidose bottle, remove bottle cap, place cap facing up on table
3. Hold multidose bottle with label against palm and pour
4. Look at cup from eye level and fill to desired level on scale. Measure from the meniscus.
5. Discard excess liquid in sink. Wipe lip and neck of bottle with paper towel.
   * * Volumes less then 10 should be drawn up with needless syringe.

Question 4

Medication Administration – Enteral Tubes

Answer 4

• Oral pills are crushed & mixed with a small amount of water
• Each medication administered separately
• Liquid suspensions should be used when available

Question 5

Managing Clogged Enteral Tubes

Answer 5

-Flush before, between and after medications/ feed
-If more then one med, flush with 15-30mL between each med
=>Warm water if clogged
=>Clamp tube and allow water to “soak”
-Reposition patient (potential kinks)
-Push and pull back on syringe plunger (do not try to force)

Question 6

Steps medication delivery via nasogastric, gastric, or feeding tubes

Answer 6

• Raise the head of the bed
• Verify tube placement
• Assess gastric residual
• Use liquid forms of medication when possible
• Identify if med can be crushed (monograph, pharmacy, scored tab)
• Dissolve each in 15-30mL of warm waer
• Flush tube with 15-30mL warm water between meds
• After, flush tube with 30-60mL warm water