med administrations via GT/NGT

TraumaICURN · Mar 14, 2007

Well I am looking for an understanding as to the proper way to administer meds with NGT/GT's. I am a nursing student, finishing in May (hopefully)....and my last two hospital placements have had complete opposing methods. Is it necessary to flush between each med, can you administer meds together, etc.? Any input would be GREATLY appreciated...

I've always either crushed all the meds together or let them melt together in water and given them all at the same time, flushing before and after. It's equivalent to the pt swallowing all their pills at the same time. It is not necessary to flush between each medicine.

TazziRN, RN · Mar 14, 2007

Textbook-wise you should give each separately and flush in between but realistically you will find that most nurses don't flush until the end and will give several together.

AliRae · Mar 14, 2007

I can't remember what we were taught in school, but I'm wondering why on earth it would be necessary to flush between each med. Do we make them swallow each pill seperately if they're capable of tossing them all back at once? I only flush them if it's one that has the potential to clog the tube. I don't like to push meds in fast, but if a med on a bigger kid requires a fast-ish flush after to clean the tube, I'll do that with a little sterile water.

GeminiTwinRN, BSN · Mar 14, 2007

It was explained to me that the reason for administering each med seperately was to be able to pinpoint which meds were actually administered in the event of a problem with the tube in the middle of giving them. That way an alternative route could be used for the remainder of the meds.

morte, LPN, LVN · Mar 14, 2007

It was explained to me that the reason for administering each med seperately was to be able to pinpoint which meds were actually administered in the event of a problem with the tube in the middle of giving them. That way an alternative route could be used for the remainder of the meds.

yup, the same reason, that crushed po meds are "supposed" to be one at a time......when there is a liquid alternative, try to get the doc to order....sometmes lns wont pay do to the higher cost...but it is easier, and safer (reduces the clog likelyhood)...carafate is one that can be a pia....good luck

RNperdiem, RN · Mar 14, 2007

I never figured out the reason behind the flush after each med rule either. Is there some research to back this up?

If a medicine patient has 8 NG meds due, and these folks have lots, that is a lot of water to give someone.

lvnstar25 · Mar 14, 2007

Okay Textbook wise you should first check for placement with 30-50cc of air...and if place...then flush the tube with 50cc of water..then begin administering meds one at a time and each med should be followed with 30cc of water.After administration of the last med you should flush the tube with 50cc of water.Different textbook have many variations however they are all similar... Many nurses dont follow this procedure because it is extremely time consuming....I will warn you though if you work at a Nursing home and STATE is in the building please utilize the text book method..State LOVES to write citations...remember thats what they get paid for!!! My only conclusion for this lenghty process is to prevent medication errors..Maybe meds such as digoxin or any meds that require for you to check VS may be the reason they want you to admin meds one at a time.If the pulse is less than 60 then you want admin digoxin etc....But then the smart nurse would say well i will check VS before I pop any of the meds then figure out what to give or not!! Basically if you always do it the correct way you will never have to worry about a MENTAL MED ERROR!! I.E...did I give that med or did I pop it or not!!Protect your pt and your Liscence!!!

jill48, ASN, RN · Mar 14, 2007

Real world: crush all the meds together. Text book: one at a time. I always assumed that the flush after each med was to prevent the tube from clogging.

AliRae · Mar 17, 2007

Okay Textbook wise you should first check for placement with 30-50cc of air...and if place...then flush the tube with 50cc of water..then begin administering meds one at a time and each med should be followed with 30cc of water.After administration of the last med you should flush the tube with 50cc of water.

This is the adult world, right? Because I'd be dealing with an awful lot of aspirations if I was giving my kiddos that much in their bellies! I usually check placement with a good 2-4ml of air, too. =)

But the giving one at a time so you know what's in and what isn't? That sounds like good, solid practice.

herecomestrouble · Mar 17, 2007

I have always crushed and given meds all together,after checking placement of course.Every nurse I know does it the same way,we all knew it wasn't the textbook way.A few years ago I got sick and was given a tube myself,I had one nurse who gave me my meds the textbook way,let me tell you it was painful,all that water.I was left with a stomach ache after each med pass and often ended up throwing up after she was done.I finally asked her to just give them all at once,she was very concerned about this and it took me a while to convince her it would be alright but I won that argument.Think about it how much water can you drink before you feel like a giant water balloon?

Gromit · Mar 17, 2007

Some of my patients get so many "po" meds that if I flushed the tube each time between meds, they would be full of fluid by the time they were done.

The only tube I REALLY worry about (because even crushed, and soaked, some meds just don't dissolve very well -like Guaifed -that granular pain in the uh, side, medication just doesn't dissolve -and for some reason (from time to time ) a doc will insist on the tab instead of the liquid. The tab doesn't dissolve or crush very well -while this is less of a problem for peg tubes and toomi syringes, try pushing it down a dobhoff tube!

Regardless, always flush well after the meds are done. I've seen pegs clog up as well because the medication just kind of settled there (though rare, it happens).

Hey, it all mixes together in the gut anyway.