I was administering med through NG Fr 10. The NG was patent and in the right place; I got 15cc residual, heard air woosh through sthethoscope, the catheter length checked out. The HOB was at least 30 deg.
The pt was fine when I flushed/pushed 50cc water. But she gagged when I let liquid Ranitidine 10cc drain down from the open syringe. The pt thought the medication reflux is causing her to gag. I asked myself, "If so, why didn't she gag when I pushed 50cc of water a minute ago?" After the med, I again flush with 50cc of water by pushing it. The pt is fine. I let the tube feeding run at 80cc/hr. The pt is fine all night. I had the pt for two nights and same thing happened every time.
First of all, why would anything draining down the NG cause one to gag?
Any chance the med has a flavor or odor that caused the gag reflex? I know some meds, pills incl, have really strong smells or tastes that are hard to tolerate. I've never tasted that liquid you're instilling so I'm just wondering
You never push medications or fluids through any type of feeding tube. You administer by allowing the liquid to flow by gravity. A feeding tube is not an IV.
That would NEVER work with a peds NGT. Definitely wouldn't work with an NJT. Sometimes even with the smaller G-tubes you'll have trouble.
Very few times in nursing that you can actually use the word "NEVER." Never push phenergan into an artery. About the only one I can think of. :)
Thank you for this information, I will do a little research on this since this is the way my nursing instructor has taught us. I am in a pediatric hospital now and this is how we were trained to give meds, push 2 ml for a flush, the med, and another 2 ml flush, using gravity has never been discussed but I will follow up with him on this method.
Gravity is better for larger diameter tubes. (Except when flushing to keep it patent, you want some pressure behind it to make sure to clear the tube so it stays patent.)
Any chance the med has a flavor or odor that caused the gag reflex? I know some meds, pills incl, have really strong smells or tastes that are hard to tolerate. I've never tasted that liquid you're instilling so I'm just wondering
Liquid zantac has a really minty smell/taste to it. Kids hate the taste of it. And from what I've smelled, I can imagine it going straight into my stomach and still not liking it. But I've got a super sensitive stomach.
amoLucia
7,736 Posts
Any chance the med has a flavor or odor that caused the gag reflex? I know some meds, pills incl, have really strong smells or tastes that are hard to tolerate. I've never tasted that liquid you're instilling so I'm just wondering