I can tell you what I would do. But that doesn't necessarily mean it is what everyone would do.
1. If my patient was out of the room when I brought his meds I'd take them back and keep them till I was able to give them myself. Never know what will happen to them otherwise.
2. If the patient is scheduled for a procedure for which he needs to be NPO, I check with the M.D. if I have any doubts, but most meds can be held and given after the procedure.
On the MAR I would put my initials and circle them. On the back would write 'meds held. Pt. NPO for procedure. Will give later' - when I gave them later I would again sign my initials under the circled ones, to indicate they'd been given.
3. If your patient vomits 15 minutes after meds are given you do not re-give the pills - no way of knowing how much had been digested. Leave till next dose due.
4. Well, if it is someone like a prisoner, or a mentally ill patient, who there is a question about such things, you could make them open their mouth after you watch them 'swallow' the pill and look inside, asking them to lift up their tongue as well.
5. If I had a adult patient refuse a med, I'd make sure they understood what the med was for and why they should take it. Then I'd ask the reason they don't want to take it. A mentally intact adult cannot be forced to take anything they don't want to. Just be sure to document it and let the charge nurse and doctor know.
6. If a drug is omitted? As in 'forgotten' to be given? It would depend on how long it was before I realized the error. If it was, say a half-hour, I'd just go ahead and give it. If close to the time for the next dose, I'd wait and make sure you again tell the charge nurse and M.D. - would need to fill out incident report if med not given for any reason.
Nah, just funning with ya! But if you are talking about oral meds what else would you give them with? Maybe I've been out of acute care too long. Are there actually oral meds not given with water? Something new to me.
8. Generally the enteric coated tabs and the extended-release capsules should not be crushed. Sure there are others but can't think of them at the moment. You can always check a drug handbook
if you have any questions about the feasibility of crushing meds.
Hope this helps.