? about rectal administration of medication

TazziRN, RN · Mar 20, 2007

Some meds can be given rectally even when intended by another route. Pills, on the other hand....especially extended release ones or enteric coated ones.........the nurse should be contacting the pt's doctor for either liquid forms of the meds or suppositories.

GingerSue · Mar 20, 2007

for rectal route, there would be meds specifically designed for rectal admin (suppository is all that I'm aware of)

unless there was something that I missed while taking the pharmacology course?

TazziRN, RN · Mar 20, 2007

Injectable Valium can be given rectally, so can Ativan.

Gromit · Mar 20, 2007

Unless its designed to be dissolved in the rectum, that won't work. I'd say this would qualify as a med error -certainly not the right 'route' for administration. I'd expect that an alternative might have been to dissolve the pills in a liquid and allow the patient to drink it (though they may well not be very high on the taste department) or better yet, crush and put in applesauce -that usually goes down easier than a solid pill. If the patient was just unable to take the meds, document and talk to a doc about alternatives.

schroeders_piano, RN · Mar 20, 2007

Actually some pills that are not enteric coated or extended release can be given sublingually and even rectally. When I worked ICU we sometimes gave some oral meds rectally. I am not an OB nurse, but I do know that they use some oral medicines given the lady partsl route. (I can't remember the names off top of my head.)

chris_at_lucas_RN, RN · Mar 20, 2007

Your reasoning is good--ask the LVN the next time you see her.

Some medications can be given by either route, but some have specific formulations for just the exact reason you knew.

Don't underestimate yourself! Certainly no one likes to be corrected, but you are new, and most people are pleased to teach someone something.

MOST IMPORTANTLY, I believe that unless the order says "may be given PR," the order must be changed by the physician, not by the LVN or RN or the med aide. If the patient is having difficulty swallowing, the physician must be made aware of the change in condition as well. Lastly, if this patient is awake and aware, she may not like having things stuffed in her bottom! Many meds can be given by other routes. Dignity is important! But the first issue is that the medication order, as apparently written by the physician, is not being followed.

Very good call--You could work with me any time! I like the way you think!

k3immigrant · Mar 20, 2007

i think the right thing to do here is to call & inform md re swallowing problem(hydration & nutrition should be addressed, too) & obtain an order for a substition for oral meds like iv or probably insert an ng tube etc instead of just giving it rectally & sign in the mar as given PO.

chris_at_lucas_RN, RN · Mar 20, 2007

i think the right thing to do here is to call & inform md re swallowing problem(hydration & nutrition should be addressed, too) & obtain an order for a substition for oral meds like iv or probably insert an ng tube etc instead of just giving it rectally & sign in the mar as given PO.

This is a problem.

If you don't chart the truth, you commit perjury, because the chart is a legal document.

This is poor nursing--don't imitate it! The right thing is what k3immigrant describes, although I assume (and maybe not correctly) that the charge nurse or might be consulted before calling the physician--but that of course depends on who calls the doc.

But please don't lie on a chart, ever.