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Administering medication through a gastrostomy tube

MCCONNELL, EDWINA A. RN, PHD, FRCNA

CLINICAL DO'S AND DON'TS
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Giving drugs through a gastrostomy tube

This department illustrates key clinical points for a common nursing procedure. Because of space constraints, it's not comprehensive. The author of this monthly column, Edwina A. McConnell, of Gorham, Me., died on October 16, 2002.

A GASTROSTOMY TUBE (GT) is an enteral feeding device placed endoscopically, radiologically, or surgically with its tip in the patient's stomach. Your primary goal when administering medication through a GT is to optimize the drug's therapeutic action without interfering with enteral nutrition.

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DO

  • Check to see whether the prescribed drug should be given on an empty or full stomach and whether tube feedings should be held (and for how long) before and after administering it.
  • Give liquid medications whenever possible to prevent clogging and enhance absorption. Dilute with at least 30 ml of water.
  • If a medication is available only in tablet form, check with the pharmacist before crushing it. Also ask about compatibility of the medication with the feeding formula.
  • If a tablet can be safely crushed, use a pill crusher to grind it to a fine powder and mix it with 30 to 50 ml of warm water.
  • Put your patient in semi-Fowler position. Keep her in this position during enteral administration and for at least 30 minutes afterward.
  • Remove the GT plug and attach a 30- to 60-ml piston syringe. (Interrupt continuous tube feedings, if necessary.)
  • Document the drug and amount given, the date and time, the patient's response, and your assessment of the insertion site.
  • Document all liquids administered, including flushes, on the patient's intake and output record.
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DON'T

  • Don't mix a medication with feeding formula or another medication.
  • Don't use a GT to administer sublingual or buccal medicines, or sustained-release tablets or capsules. Never crush enteric-coated medications, which could result in improper drug absorption.
  • Don't reclamp the tube after administering a medication without flushing it.
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SELECTED REFERENCES

Guenter, P.: “Medication Administration,” in Tube Feeding: Practical Guidelines and Nursing Protocol, P. Guenter and M. Silkroski (eds). Gaithersburg, Md., Aspen, 2001.
    Nursing Procedures, 2nd edition, Springhouse Corp., Springhouse, Pa., 2000.
      © 2002 Lippincott Williams & Wilkins, Inc.