Chapter 6. Non-Parenteral Medication Administration Show
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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 of the following nursing actions help reduce the risk of aspiration?Upright positioning decreases the risk for aspiration. Instruct in signs and symptoms of aspiration. Information helps in appropriate assessment of high-risk situations and determination of when to call for further evaluation. What nursing actions should the nurse take to administer medications safely?Nurses' Six Rights for Safe Medication Administration. THE RIGHT TO A COMPLETE AND CLEARLY WRITTEN ORDER. ... . THE RIGHT TO HAVE THE CORRECT DRUG ROUTE AND DOSE DISPENSED. ... . THE RIGHT TO HAVE ACCESS TO INFORMATION. ... . THE RIGHT TO HAVE POLICIES ON MEDICATION ADMINISTRATION.. Which intervention should the nurse implement when administering sublingual medication?Sublingually: Place medication under patient's tongue and allow to dissolve completely. Ensure patient avoids swallowing the medication. Which action would the nurse take when the patient who is nothing by mouth?If your patient has a nothing by mouth (NPO) order, verify if this includes all medications. This information may be included on the MAR or the orders, and if not, verify this information with the provider. What should the nurse do when administering drugs by nasogastric tube?Attach syringe labeled with medication to tube port and slowly instill diluted medications into the NG tube by slowly and steadily pushing on the plunger. c. Follow administration of medication with 1-10 ml of diluent as ordered.
What safety measures should the nurse implement to prevent aspiration?PREVENTION OF ASPIRATION DURING HAND FEEDING:. Sit the person upright in a chair; if confined to bed, elevate the backrest to a 90-degree angle.. Implement postural changes that improve swallowing. ... . Adjust rate of feeding and size of bites to the person's tolerance; avoid rushed or forced feeding.. What should be done prior to administration of medications by NG tube?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.
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