Mixing GT meds

[Mrs. M.]

When you administer crushed pills via GT, do you dilute each one in water separately, or do you combine them? Our facility has always allowed us to combine them (assuming they are crushable and compatable), but we can't find any resource that says it's okay to do that. They all say to administer them one at a time. What is your practice?

[BeckyRN2006]

Our rationale is by separating the meds, you know exactly what they are getting. If for some reason there is a spill or your syringe would come undone, you know what has went in and what you have left. But of course, cocktails are easier.

[nightmare, RN]

Most of our meds for G/T or PEG are liquid form but the rule is crushed first then flush ,then liquids so that the liquids keep up the flushing movement down the tube.These are then flushed out after last liquid given.

[herecomestrouble]

speaking as someone who had a Gtube for 6 months,giving them separately with a flush in between each med usually left me feeling like a water balloon that was ready to pop,and often times I did pop,which didn't make the CNA who had to clean up my bed too happy:madface:.I only had one nurse who did meds this way and it took a lot of arguing on my part to get her to give them all together.I always mix them and give at once to my pts now.

[CapeCodMermaid, RN]

speaking as someone who had a Gtube for 6 months,giving them separately with a flush in between each med usually left me feeling like a water balloon that was ready to pop,and often times I did pop,which didn't make the CNA who had to clean up my bed too happy:madface:.I only had one nurse who did meds this way and it took a lot of arguing on my part to get her to give them all together.I always mix them and give at once to my pts now.

First off, I hope you are fully recovered.

Secondly, no matter what practice has worked for us personally, we all have to follow our facility's policy on med administration.

I had a mastectomy years ago. For my postop exercise program, the doc told me to do either wall walking or hang laundry. 3 days after I got home from the hospital, I was in my kayak in the ocean paddling for exercise. Did it work...it worked great (although all these years later the doc still gives me grief over it). Would I recommend it to anyone else? Absolutely not.

Policies are there for a reason and we must follow what our particular facility's policy are.

[TrudyRN]

JCAHO wants them separate in 10 cc H20, then a flush after each one, of a few cc.

The reason to give them separately is, for instance, what if you mix them all together and get halfway through giving them and have to stop. Either you must rush to some emergency, your pt can't tolerate the rest of the meds just then, or whatever. Suppose you can't get back to finish for a while or ever. How are you going to chart that?