G-tube medication question

  1. 0 When giving G-tube meds, I am just wondering if all students are required to give one at a time with 10cc of water between meds? Would you give a liquid med (consistency of water) with a crushed med, or would you seperate them as well? Nurses on the floor are laughing because they think this is just rediculous!!:stone
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  3. Visit  dcoffee profile page

    About dcoffee

    From 'Los Angeles County, CA'; 48 Years Old; Joined Oct '03; Posts: 36.

    34 Comments so far...

  4. Visit  lpn1313 profile page
    0
    Proper administration of meds is one at a time. Mixing any meds together causes chemical changes in the medication- as I was told in nursing school. That being said- some nurses do mix them together for speed and ease of administration.
  5. Visit  ProfRN4 profile page
    0
    Quote from dcoffee
    When giving G-tube meds, I am just wondering if all students are required to give one at a time with 10cc of water between meds? Would you give a liquid med (consistency of water) with a crushed med, or would you seperate them as well? Nurses on the floor are laughing because they think this is just rediculous!!:stone
    Yes, some may see it as rediculous, but you have to consider a few things. The size of the tube (NG tubes, for example tend to clot easier and are thinner). If it is a GT button, they are usually very thin. I remember opening a capsule filled with little balls and it getting clogged in a tube because they didn't pass through (and no, you're not supposed to open capsules because it defeats it's purpose- but when everyone has been doing it and the pt doesnt take pills, well, I guess you get the point...)

    In peds, the tubes are much smaller, so you really have to be careful. But at the same time you wouldn't want to flush with 10cc between each med (on a small child, as they end up vomiting all the meds you give them). If it is adult, who needs fluid restriction, then that may be too much in between meds.

    As far as mixing them together, not a great idea. If, God forbid the tube gets clotted while you are giving your 'cocktail' of 5 meds, you'll have a big problem figureing out exactly what the pt. got and what he didn't get.
  6. Visit  not now profile page
    0
    I learned how to administer meds to GT patients on a subacute floor. Everyone on my med pass was a GT and my instructor always had me crush the meds together, mix with water (or prune juice), pour it into the ginormous syringe, let gravity take it's course and flush with water. Her reasoning being "You may take them seprately by mouth but when they break down in your stomach there will be nothing stopping them from mixing."
  7. Visit  VivaLasViejas profile page
    0
    Well, you learn something new every day.........

    When I worked in LTC, there was absolutely NO time for giving G/tube meds one......at......a.......time.......we always had at least three or four tube feeders with LOADS of medications, and if we'd taken that much time we'd never have completed our med passes! So what I always did was flush the tube, crush all the pills that could be crushed and give them together with a little water, flush, then give the liquid medications (vitamins, Tylenol etc.) together and flush once more. Otherwise, you tend to end up with this yucky precipitate that looks absolutely disgusting and stinks to high heaven, plus you can easily clog the tube.

    I never had a problem with this method, and I was able to get it done and over with quickly.
  8. Visit  dcoffee profile page
    0
    Quote from not now
    I learned how to administer meds to GT patients on a subacute floor. Everyone on my med pass was a GT and my instructor always had me crush the meds together, mix with water (or prune juice), pour it into the ginormous syringe, let gravity take it's course and flush with water. Her reasoning being "You may take them seprately by mouth but when they break down in your stomach there will be nothing stopping them from mixing."
    Can I ask where in California you are in school, in the event I fail this rotation and can't go on?!?!?!?! Are you still a student? What do you think would happen if you failed one clinical rotation where you are/went to school?
  9. Visit  shape0fmyheart profile page
    0
    My clinical teachers and the nurses that I've been paired up with have all had me crush them all together...
  10. Visit  deegale profile page
    0
    Quote from here with me
    My clinical teachers and the nurses that I've been paired up with have all had me crush them all together...
    YOUR FACILITY SHOULD HAVE A P/P ON GIVING MEDS/FLUSH THRU G-TUBE WE CAN MIX MEDS BUT IT IS OUR RESPONSABILITY TO KNOW WHICH ONES ARE COMPATABLE THEN FLUSH WITH 5-10CC OF H2O FOLLOWING
  11. Visit  Aneroo profile page
    0
    In nursing school world, you are supposed to crush the seperately, because some meds don't mix well. I would crush mine, then mix with water, then pour that in, then flush with water. Don't forget that all of those flushes and sorts go into your I/O's! Also don't forget to clean out whatever you were crushing the pills in- you don't want to cross-contaminate another clients meds. All that being said, that's nursing school nursing. I am assuming that in "real" world nursing, they mix them all together and give all together. However, we're taught to do things a certain way in nursing school because there is a scientific reason to do so. -Andrea
  12. Visit  ProfRN4 profile page
    0
    Quote from aneroo
    in nursing school world, you are supposed to crush the seperately, because some meds don't mix well. i would crush mine, then mix with water, then pour that in, then flush with water. don't forget that all of those flushes and sorts go into your i/o's! also don't forget to clean out whatever you were crushing the pills in- you don't want to cross-contaminate another clients meds. all that being said, that's nursing school nursing. i am assuming that in "real" world nursing, they mix them all together and give all together. however, we're taught to do things a certain way in nursing school because there is a scientific reason to do so. -andrea
    are you saying nursing school is not the real world?!?!?!? :chuckle :chuckle :chuckle :chuckle :chuckle :chuckle :chuckle
  13. Visit  not now profile page
    0
    Quote from dcoffee
    Can I ask where in California you are in school, in the event I fail this rotation and can't go on?!?!?!?! Are you still a student? What do you think would happen if you failed one clinical rotation where you are/went to school?
    I'm in the central valley about an hour north of Bakersfield.

    Yes I'm still a student, I graduate May 25th. My last clinical day is this Wednesday, then we go into "Mock Boards" for four weeks instead of clinic. We take our respiratory final on Friday and go into our nero module until the end of school (we take one module at a time).

    If I falied one clinical rotation the department head would kill me (I've known her since I was a kid) and I would have to repeate the semester if there was room for me in the class.
    Quote from Aneroo
    Also don't forget to clean out whatever you were crushing the pills in- you don't want to cross-contaminate another clients meds. -Andrea
    I'm confused. What are you crushing meds with? When I did subacute we crushed meds in a little baggie that slid into the pill crusher (God that's a horrible description), made sure it was fine as we could get it, then poured it in a cup. The baggie got thrown away after each use.
  14. Visit  madwife2002 profile page
    0
    The problem you can face by crushing and flushing some medications is that they are not licenced to be crushed and flushed down tubes, so the drug companies will take no reponsibility for side effects ect.

    You are supposed to do each medication seperately and flush with 10mls of water after each medication.

    Coke ( especially coke-a cola) is great for de-bunging tubes has anybody tried that lol dunno if it is lisenced for flushing tubes or not
  15. Visit  Gompers profile page
    0
    Wow, this thread is an eye opener to me! I can't imagine flushing a GT or NG with 10cc of water after every single medication! That just sounds ridiculous to me. I work in NICU now, the land of fluid restrictions, but I was a CNA on adult floors and watched the nurses giving meds all the time. I remember that they just gave them all at once and flushed them in afterwards, not after every single med.

    I do understand that some meds are not supposed to be given at the same time because of absorption issues, etc. So yeah, those should be scheduled and administered at the proper times. But other meds...they all mix in the stomach anyways, it really doesn't make a difference if you mix them a minute before they hit the stomach via an NG or GT, or if the person swallows the pills and they mix naturally. Plus you have the meds that should never be crushed, like extended-release things, but that's a whole other thread.

    With our babies, we give NG meds all the time and sometimes GT as well. With kids on feedings, we just schedule the meds to coincide with the feedings. We have liquid meds or once in a while crushed meds, and we just add them to the entire feeding, shaking gently to distribute, and feed as normal. If the baby is NPO except for meds, we ive the meds (mixing crushed meds with 1-2cc of sterile water) and flush with 1-2cc of water. Our G-tubes have much larger tubing than our NGs, 14-french as opposed to our 5, 6.5, or 8-french NGs.

    If I got floated to peds or adults (which of course never happens) and had to give G-tube meds...I'd just d them the same way I give our babies G-tube meds. Clamp off the tube, put a large syringe on it, pour in some water or liquid feeding into the syringe, and throw the meds in there. Place plunger on syringe, shake gently, remove, then open the clamp and let the meds go in by gravity. If a little remained in the tube, I'd either push a cc or two of air to clear the tube, or use a bit of water or feeding to clear the tubing.

    Just saying what I'd do, and I give tube feedings and NG/GT meds almost every single day I work.


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