Giving meds crushed in applesauce

[anastasia158]

As we all know, when someone takes oral meds, they take them all at once with water. Today I was administering meds with my clinical instructor. I was to give crushed meds in applesauce. I had them all crushed and was thinking that I could place all the crushed meds in applesauce, mix it and feed all of the applesauce to the patient.

However, my instructor had me separately mix each medicine in its own plastic cup of applesauce. This ended up being time consuming and I am trying to figure out why that would have been necessary. My instrictor ended up getting upset with me over how putzy it ended up being.

[txredheadnurse, BSN, RN]

Some of the facilities I visit are pretty creative in what they mix their crushed meds into such as jelly, sugar free pancake syrup, frozen lemonade and peanut butter. I have used the peanut butter when I worked with DD clients who had severe tongue thrusting. It kept the meds intact and in the mouth.

To the OP yes you need to do it the way your instructor wants you to do it for now. And, yes, in the perfect world one would have sufficient time to encourage patients to take their meds one at a time. However, few, if any LTCs have the luxury of having only 4-7 folks to give meds to during a med pass. The load can run as high as 50+. Painstaking crushing and mixing of individual meds would be an all day or night ordeal. Personally if I needed my meds crushed I wouldn't want you shoving multiple spoonfuls in my mouth. I dare so most residents don't either.

[jocelynlpn, LPN]

That's the difference between real world and nursing school.Many of my patients get their pills in applesauce not because they won't take them whole, but rather they can't.The only time I put them in a separate cup if there is a chance of refusal and it's something important like sedation medication.

I agree. I have a resident who refuses her meds a lot of the time. (mostly because she takes Tylenol and crushed Tylenol tastes horrible) She's on seroquel so I always crush the seroquel seperately and give it to her first, she takes it just fine.

[txredheadnurse, BSN, RN]

I agree. I have a resident who refuses her meds a lot of the time. (mostly because she takes Tylenol and crushed Tylenol tastes horrible) She's on seroquel so I always crush the seroquel seperately and give it to her first, she takes it just fine.

Why don't you ask the doctor to change the tylenol to liquid form? It doesn't have that nasty taste of the tablets.

[Forever Sunshine, ASN, RN]

Xtrn, the jelly trick is one my self-described "old ICU nurse" of a clinical instructor showed me with one little lady in med/surg that was giving me a bit of a hard time. She was able to swallow them & didn't need crushed, but was confused. Worked wonders.

Also, during a few days of med pass on an alzheimer's hall for my LPN exit, I was shown to crush everything and mix with chocolate or vanilla pudding, just a bite full. Only had a couple incidences where the resident didn't want it but after a little distraction by talking about some odd topic or walking away and coming back after a couple minutes, they always took it, no problem.

I'll remember the jelly trick next time.

[jocelynlpn, LPN]

She has liquid tylenol ordered if she refuses the pill form. I call it her "cherry whiskey"