Medication Administration Oral Medication Part III Karen Malt, MSN, RN

Administering Oral Mediations by Enteral Tube Enteral tubes are used when a client cannot swallow oral medications. Because the lumen (opening or bore of a tube, or the cavity of a tubular organ) of a tube is smaller than the esophagus, special consideration must be maintained to avoid obstruction or blockage. Nurses use slightly different techniques for administering medications through an enteral tube used for nourishment than they do for decompression (suctioning). Decompression – clamp or plug the tube for at least 30 minutes after instilling the medications to prevent removing the drug through the suction before it leaves the stomach. Nourishment – Instill the medications separately. DO NOT ADD THE MEDICATIONS

Documentation Note : If the nurse uses a bar code drug administration system, documentation will be immediate. If not, The MAR must be filled out by the nurse manually. Documentation in the client’s chart when an enteral tube is in place. Document in a timely manner to prevent medication errors. Why ? * Be aware if a client refuses a dose, or a nurse withholds a dose, it must be documented. Many facilities initial as usual, but circle the initial of the nurse. The nurse should document the reason for the omission.

Preparing Medications for Enteral Tube Administration 1. Use a liquid form of the medication. 2. Add 15ml – 60 ml of H2O to thick liquid medications. 3. Pulverize tablets with a mortar and pestle (Except those that are enteric coated). 4. Open a shell of a capsule to release the powdered drug. 5. Avoid crushing SR pellets. 6. Mix each drug separately with at least 15ml – 30 ml of H2O. 7. Use warm water when mixing powdered drugs. 8. Pierce the end of a sealed gelatin capsule and squeeze out the liquid medication or aspirate it out with a syringe. 9. As an alternative, soak a gelatin capsule in warm water for approximately an hour. Soaking dissolves the gelatin capsule. 10. AVOID giving bulk laxatives in the enteral tube as this could block the tube. 11. Interrupt a tube feeding 15 – 30 minutes before and after instilling a drug that should be given on an empty stomach. 12. Clamp a Nasogastric (NG) tube for 30 minutes after instilling medications.

Exercise Directions: Each group has been given a client scenario. Prepare the medications ordered for the client assigned. Be Prepared to discuss each drug, what it is used for and how it was specially prepared for the client with an enteral tube.