Chapter 6. Non-Parenteral Medication Administration Show
Medication by MouthMedication is usually given orally, which is generally the most comfortable and convenient route for the patient. Medication given orally has a slower onset and a more prolonged, but less potent, effect than medication administered by other routes (Lynn, 2011). Prior to oral administration of medications, ensure that the patient has no contraindications to receiving oral medication, is able to swallow, and is not on gastric suction. If the patient is having difficulty swallowing (dysphagia), some tablets may be crushed using a clean mortar and pestle for easier administration. Verify that a tablet may be crushed by consulting a drug reference or a pharmacist. Medications such as enteric-coated tablets, capsules, and sustained-release or long-acting drugs should never be crushed because doing so will affect the intended action of the medication. Tablets should be crushed one at a time and not mixed, so that it is possible to tell drugs apart if there is a spill. You may mix the medication in a small amount of soft food, such as applesauce or pudding. Position the patient in a side-lying or upright position to decrease the risk of aspiration. Offer a glass of water or other oral fluid (that is not contraindicated with the medication) to ease swallowing and improve absorption and dissolution of the medication, taking any fluid restrictions into account. Remain with the patient until all medication has been swallowed before signing that you administered the medication. Checklist 44 outlines the steps for administering medication by mouth. Checklist 44: Administering Medication by Mouth
Medication via a Gastric TubePatients with a gastric tube (nasogastric, nasointestinal, percutaneous endoscopic gastrostomy [PEG], or jejenostomy [J] tube) will often receive medication through this tube (Lynn, 2011). Liquid medications should always be used when possible because absorption is better and less likely to cause blockage of the tube. Certain solid forms of medication can be crushed and mixed with water prior to administration. Checklist 45 outlines the steps for administering medication via a gastric tube. Checklist 45: Administering Medication via a Gastric Tube
Which action would the nurse implement when feeding a patient who is prescribed aspiration precaution?The nurse should elevate the head of the bed to a 90-degree angle prior to feedings for any patient who is prescribed aspiration precautions.
Which interventions help decrease the risk of aspiration during feeding?Nursing Interventions for Risk For Aspiration. Keep suctioning equipment at the bedside. ... . Performing suctioning as necessary. ... . Keep the head of the bed elevated after feeding. ... . Implement other feeding techniques. ... . Consult with speech therapy. ... . Follow diet modifications. ... . Position properly.. How often should the nurse check gastric residuals for patients who are prescribed aspiration precautions?The Pre-brief
The theory behind checking residuals is based on the assumption that a full stomach predisposes ventilated patients to aspiration and VAP. Based on this, experts initially suggested checking residuals, typically every 4-6 hours, for the large quantities of feed and gastric content.
Which assessments should be made for a patient receiving tube feedings?Objective assessments for patients with enteral tubes include assessing skin integrity, tube placement, gastrointestinal function, and for signs of complications: Assess the tube insertion site daily for signs of pressure injury and skin breakdown. Cleanse and protect the area as indicated.
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