Pharmacology Chapter 8

Administration of Enteral Feedings via Gastrostomy or Jejunotomy Tube

•Follow the guidelines specific for patients receiving general nutrition via intermittent or continuous feedings •Verify tube placement, assess for residual, and initiate feeding •Flush with 30 mL water, then clamp tube •Proceed with tube feeding technique •Intermittent: Use Toomey syringe •Continuous: Use disposable feeding container and enough formula for a 4-hour period •Check gastric residual volume before next feeding; listen for bowel sounds •Provide complete documentation of administration and response to therapy

liquid oral form medications

•General procedures are the same as with solid-form oral medications •Perform premedication assessment in all cases •Liquid medications are most commonly given to infants using a syringe or dropper •Place the syringe between the cheek and gums, halfway back into the mouth, and slowly inject medication to allow the infant to swallow •General principles for infants, children, and adults •Give adults and children the most important medications first •NEVER dilute medications without specific orders •DO NOT leave a medication at the bedside without an order to do so •Check an infant's ID and be certain the infant is alert •Provide complete documentation of administration and responses to therapy •Measuring techniques vary according to receptacle used •Measuring cup: Cover label to prevent smearing; place fingernail at exact level on measuring cup; read the volume at the level of meniscus •Oral syringe: Select syringe of appropriate size; draw up prescribed volume of medication from bottle or medicine cup

Administration of a Disposable Enema

•The dose form will be a prepackaged, disposable-type enema solution •Technique begins with the seven rights •Explain procedure and check pertinent parameters •Time of last defecation •Position patient on left side •Apply lubricant to rectal tube •Insert lubricated tube and insert solution •Educate •Document

enteral administration

1.Describe general principles of administering solid forms of oral medications. 2.Compare the different techniques that are used with a unit-dose distribution system and a computer-controlled dispensing system. 3.Identify general principles used for liquid-form oral medication administration. 4.Cite the equipment needed, techniques used, and precautions necessary when administering medications via gastrointestinal tubes. Cite the equipment needed and the technique required when administering rectal suppositories and disposable enemas

Administration of Rectal Suppositories

•Suppositories are solid medication designed to dissolve inside a body orifice •Equipment is simple •Finger cot or disposable glove •Water-soluble lubricant •Prescribed suppository •Perform standard premedication assessment •Should not be used for patients who have had recent prostatic or rectal surgery, or rectal trauma •Technique •Procedure protocol •Seven rights •Wash hands, don gloves •If possible, ask patient to defecate prior to administering suppository •Provide privacy, drape, position on left side •Use water-soluble lubricant, insert suppository about an inch beyond internal sphincter

oral administration

•Capsules: Small, cylindrical gelatin containers used to administer unpleasant-tasting medications •Timed-release capsules provide gradual and continuous release of a drug •Lozenges: Flat disks in a flavored base •Tablets: Powdered drugs that have been compressed •Orally disintegrating tablets: Rapidly dissolve on tongue within seconds •Elixirs: Drugs dissolved in water and alcohol •Emulsions: Dispersions of small droplets of water in oil or small droplets of oil in water •Suspensions: Liquid dose forms that contain solid, insoluble drug particles dispersed in a liquid base •Liquid suspensions; syrups •Common methods used to administer oral medications •Unit-dose packaging: Provides a single dose •Soufflé cups •Medicine cups: Read at eye level •Medicine droppers •Teaspoons •Oral syringes: Plastic syringes calibrated and used to measure liquid medications •Nipples with additional holes: Used for infants

medications by gastrointestinal trubes

•Drugs are administered via nasogastric (NG), nasoduodenal (ND), or nasojejunal (NJ) tubes for specific patients, using a liquid form whenever possible •Gastrostomy or G-tubes: surgically inserted through the abdomen into the stomach •Percutaneous endoscopic gastrostomy (PEG): procedure during which gastrostomy tube is inserted •Remember •Check the location of the GI tube before administering any liquid •Always flush the tube before and after administration with 30 mL of water •Perform premedication assessment •Assemble equipment before administration •Flush between each medication with 5 to 10 mL of water •Prepare doses as for administration of solid- or liquid-form oral medications •Follow procedure for administering medication •DO NOT attach suction for 30+ minutes •Provide complete documentation of administration and responses to therapy medical

Solid form of oral medications

•General principles apply to all distribution systems •Give the most important medications first •Do not touch the medication with your hands •Encourage liquid intake to ensure swallowing •Remain with patient while medication is taken; DO NOT leave the medication at bedside unless an order to do so exists •Discard the medication container