G - tube

[jessicaRN32]

I work in a long term care facility and I have a resident that has a G - tube. This resident is prescribed liquid morphine (1 cc). Some people administer it through the G - tube, and some people administer it orally so that it can dissolve in the resident's mouth.

My question is, is there a "most correct" way to do it? Are one of those administration's wrong? How do you/would you administer it?

[loriangel14, RN]

The order should say what route to give it. I would give it via the tube but you should check with the MD if you have questions.

[JustBeachyNurse, LPN]

My father was on hospice and had a GT. His morphine order was 10mg/mL give 2-10mg sublingual. The route must be specified to be a valid Rx

[RN_2012, BSN, RN]

Usually this is a liquid sublingual not to be through g-tube which defeats the purpose.

[SouthernPoint]

Like others have said. The order should state the route. But with previous experience. It's given orally. Better and quicker absorption.

[chopwood carrywater]

Like others have said. The order should state the route. But with previous experience. It's given orally. Better and quicker absorption.

Our hospice NP has brought in articles that show that it is as effective if not more so when given PO and swallowed i.e. Get it to the GI system. And if given buccally, it is poorly absorbed.

It's midnight so I'm not going to hunt online for a article to reference but I believe they are out there. Maybe I'll look tomorrow.

[misstrinad]

I have a pt I've taken care of several times now and his morphine order states to be given through the g tube. If the Mar doesn't say which route I always run and check the chart.

[~PedsRN~, BSN, RN]

If the order doesn't have a route, I would check with physician/pharmacy about effectiveness. But man, I love a good Gtube med.

[nurseprnRN, BSN, RN]

If you're giving 1cc orally and it's swallowed, that's not going to get into the stomach much-- it will coat the esophagus and be absorbed through the mucosa, just like the oral mucosa where it was deposited in the first place.

Get the formulation that's maximally concentrated (sounds like you have that already, if it's only 1cc) and give it sublingually. It will eventually run down the pharynx anyway, but mostly will be absorbed through the oral mucosa. And for heaven's sake, get the prescription to specify route. Shame on all those nurses that went before you that made up their own.

[chopwood carrywater]

Here is one of the documents I mentioned earlier of SL vs PO administration of morphine. In any case one should definitely not give it buccally as it does not allow for effective absorption of the medication.

[Kaltia]

It's not really about route here but the fact that it's not specified. It's not a valid order without a route. Clarify the order, based on what little we know of the patient, I'd guess they'll get more of the med if it goes through the g-tube, however, it probably needs to be switched to a non-sublingal form.