G-tube medication question

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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

Specializes in NICU.

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.

Specializes in Pediatrics.

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.

Some places use a generic pill crusher- it's like a glass or plastic cup with an inverted type of cup that you put over the med (can't figure out how to explain it better- something you'd buy for home use). There's no baggie (I know what you're tlking about) or paper med cups involved, so the powdered med is actually in a cup that's reusable. You don't know how mny times I grab the pill crusher, only to find someone else's crushed med leftover still in there :angryfire :angryfire

Specializes in SNF.
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.

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.

we crush the med in the bag and pour them in a cup, but unlike nurses do, all meds in one cup, we have to administer one at a time with 10cc of H20 inbetween each med. I had mixed KCl liquid form with a crushed pepcid together, thinking ok, one liquid, one crushed, no problem, no more of a risk of a clog then if I was doing it with water! Congratulations on your upcoming Graduation, if I don't get kicked out, I'll be graduating June 16th!!!!:uhoh3:

Specializes in LTC, assisted living, med-surg, psych.

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 :rotfl:

Uh......I don't think the makers of Coca-Cola (or any other soda pop) ever intended their product to be used in this fashion, but I'm here to attest that it works! It doesn't de-gunk every clog, of course, but it works more often than not....for some reason I've found the diet version does an even better job, although some people don't notice a difference. I got in that habit years back because a) diet soda was all I ever had on hand, and b) most of my tube feeders were diabetic. :)

Specializes in Emergency & Trauma/Adult ICU.
we crush the med in the bag and pour them in a cup, but unlike nurses do, all meds in one cup, we have to administer one at a time with 10cc of H20 inbetween each med. I had mixed KCl liquid form with a crushed pepcid together, thinking ok, one liquid, one crushed, no problem, no more of a risk of a clog then if I was doing it with water! Congratulations on your upcoming Graduation, if I don't get kicked out, I'll be graduating June 16th!!!!:uhoh3:

Yes, you need to take care that the tube doesn't become clogged. (thanks for the diet soda tip, mjlrn! :) ) But think about this -- your patients who are able to take meds by mouth -- don't they often swallow several at a time? I don't understand the reason to flush between each med. I'm not talking about meds that shouldn't be crushed - that's a separate issue, and the hospital will have a policy about that - just ask the pharmacy.

When I've given meds via G-tube I've done what my instructors, the floor RNs and the hospital pharmacy have all directed us to do: crush, mix with a sufficient amount of slightly warm water, draw up the entire "cocktail" into a 60cc syringe, administer, then flush.

We always used club soda for the tube clears. Brings back memories of milking the tubes as well. The worst was liquid colace, the stuff will explode back at you...

Specializes in LTC, med-surg, critial care.

About the soda in the GT thing: I work in a LTC to get myself through school. One of my classmates said "My friend worked there as an LVN and she left the place immediately because they were flushing the GT's with soda!" I could not for the life of me figure out why it was a bad thing (I had never seen it). I guess it's not?

Specializes in NICU.

I've heard that Coca-Cola is actually great at a lot things, everything from cleaning toilets to unclogging drains. So it makes perfect sense to me to use it to clear a feeding tube. Of course water probably works best most of the time, but if there is a true clog...what is the harm in using some soda (diet soda for diabetics, of course)? We can't do it with the babies, but I could totally see it with adults.

Never underestimate the power of Diet Coke, I say.

'Tis the nectar of the gods.

Specializes in ICU, PICC Nurse, Nursing Supervisor.

I have always said there is the nursing school - textbook way, then the real world way. I had to do as the original poster suggested in nursing school, seperating each med flushing between ...BLAH BLAH BLAH. But in the real world I have yet to see any nurse seperate the meds. And I have crush orders on every med I give (Of course If there is no Liquid substitute). With the exception of a few meds ,they are all crushed.If they cant be crushed they go in the hinny. I love coke . I might be helpful to mention as well that you can put the coke in the tube , cap it off and leave it for about 15-30 min and that will get rid of ANY clog.

I was told to use Sprite/7-up b/c it is colorless.....but it all works the same!

Specializes in forensic psych, corrections.

Yeah, I actually think its the carbonation that helps clear it, as I've also used ginger ale, and that works just as well as the coke.

When I was in nsg school on my pharm rotation, we mixed all the meds together and gave them like that and flushed afterwards. Right now I only have one kid on GT meds, and I mix them together (they are all liquids) and administer them with a water flush. I've never heard that you should give one med at a time and flush in between.

Specializes in RN, BSN, CHDN.

This has been a very intersting thread and I have enjoyed reading everybody's comments especially re the coke use, glad I can continue to use it once I work in US. :rotfl:

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