GT meds when pt eats PO

Nurses General Nursing

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I'm a new LVN working at a SNF. I have a question.. but I hope I don't sound dumb asking this. I have a patient who eats by mouth but receives meds through GT. The medication I give on PM shift are Coreg,Catapress,Bacid, and Valproic Acid. The problem is the patient always either refuses or only wants a little of the medication ( I know that's not correct to crush all meds and combine you're supposed to seperate them per correct guidelines but that's another topic..) anyway...he refuses or only wants a little of the medication because he states it "makes him feel like vomiting" my question is why must the meds be administered through GT? I don't have the knowledge about how absorption of the meds works so I will have to research as I'm sure thats the reason they aren't given by PO. also why do you think the patient has n/v due to the medication??

i love this website. i visit it everyday when i get off work to research new topics. thanks in advance!:loveya:

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I can't figure out why the pt has a GT if they are eating regularly. Those meds are going in hard, being introduced/utilized incorrectly, and probably are causing all the GI irritation. Replacing a gastric tube if it turns out to be needed seems a lot better than dealing with a patient refusing to take meds, having a GT, and dealing with constant n&v issues.

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There are patients that are able to eat regularly but will not take their meds orally for whatever reason. If the person has a G-tube, it tells you that there was some type of issue in the past with taking foods/meds orally. Some that can take food are unable to swallow pills. You also do not mention the type of diet that the patient is on.

Best suggestion is to always contact the provider in cases like this. Sometimes things are just overlooked from when they started to eat, and other times there is a specific reason why this needs to be followed.

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Specializes in A little of this & a little of that.

Agree with Suzanne, contact the provider for further orders. You'll get a better idea what the rationale is and what can be done. Maybe changing med times would help. It sounds like this patient probably didn't want the meds po either.

I have seen Gt's left in once a patient is able to eat and used for giving meds. Especially if med dosage is critical. When you crush meds and give orally, varying amounts of each dose are left in the cup and on the spoon with the applesauce. Even though some of the med is left behind when you administer via GT, the dosing is more consistent. They also will leave them in for awhile "just in case".

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I'll be curious to see what you find out. Pls let us know!

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Are you crushing the Valproic Acid? Most are EC and if you crush you lose the protective coating. Once saw a man almost bleed to death because of this.

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Specializes in LTC/Rehab, Med Surg, Home Care.

Depakote sprinkle capsules can be opened and passed through a G-tube.

Are you crushing the Valproic Acid? Most are EC and if you crush you lose the protective coating. Once saw a man almost bleed to death because of this.
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The valproic acid is in liquid form to answer the question above whether I crush or not.

The patient's diet is Mechanical Soft, NCS Extra Gravy, Thin Liquids.

I forgot to add he has a diagnosis of Pancreatitis if that matters or not...

I will investigate this further the next day I'm at work which is Thursday. I'll let you know what I find out.

Anyway, thanks for all the replies!

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Ooh..i googled valproic acid and pancreatitis and I'm finding a lot of info stating it shouldn't be given to patients with pancreatitis or that it may cause it... true not true? hmm..

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You might want to post this question on the med savvy thread.

Glad to know that at least liq. was being used. Go to remind us, Sunny, about the capsules. Sometimes people are not thinking and add capsules in to be crushed. The beading surrounding the med can be broken and allow med to escape.

I have seen liver prob. from Depakote but don't easily recall pancreatitis. I trust the med. lit. so it probably should be further investigated and discussed with MD.

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Specializes in Med Surg, LTC, Home Health.

The pancreatitis is an old dx or the pt would not be eating.:)

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I think the underlying question is does this drug have the potential to trigger further problems with pancreas.

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