The following is a link to a recent article from the October 2009 issue of AJN about tube feeding, and how it should be performed. I know that we aren't supposed to mix meds or combine meds with feeding. Plus, we should flush between each med. However, I was surprised to see that it states sterile water should be used for flushing and diluting through a G-tube, not tap water:
A few questions: do any of you use sterile water for tube feeding medications? If tap water is bad for tube feeding meds, then shouldn't it also be bad for oral medications? Or to have patients/residents drinking it, in general? (Or us, for that matter?!) I was never taught to use sterile water in school for tube medications.
I have always used tap water. It is what we give all of the other patients to swallow their pills with. Should we give everyone sterile water to take their meds and to drink?
I don't think it's that unusual for tap water to have some contamination with bacteria or fungi. For most people, it's not a big deal. When we suction, we take away the stomach acid that is a defense for oral ingestion of pathogens. So, I can kindof see it but agree that it's a bit much.
Yeah, I have time to crush and mix each med separately. Sure. And pigs fly. And how the heck does room temperature sterile water dissolve meds well enough to get them through without clogging the tube?
When people take them PO they all go down together. Am I supposed to crush each pill separately, too?
In one of the facilities that i work the pulmonologist insists on using sterile water for gt flushes. Seems he read in some journal that it decreases the incidence of PNA. All his patients are on trach/vent also.
The only time we use sterile water for flushes is if the patient had stomach surgery. I also don't give meds one at a time, too labor intensive, not to mention the flushing in between each med. That could add up to a lot of extra water which some patients could not tolerate.
The only time we use sterile water for flushes is if the patient had stomach surgery. I also don't give meds one at a time, too labor intensive, not to mention the flushing in between each med. That could add up to a lot of extra water which some patients could not tolerate.
since giving the meds singly is the usual expectation, it is best to get a doctor's order " may administer all meds together".......of course have to check with pharm for contraindications....
Yeah, I have time to crush and mix each med separately. Sure. And pigs fly. And how the heck does room temperature sterile water dissolve meds well enough to get them through without clogging the tube?
When people take them PO they all go down together. Am I supposed to crush each pill separately, too?
Gah.
I've always wondered about why tube fed meds cannot be mixed together, nor crushed together, but oral meds can be given together. I mean, for tube meds, you put one in, flush with water, then put another one in, so only a few seconds separates the medications. Do those few seconds really make a difference in preventing interactions, since they'll all be together in the stomach?
Yeah, I have time to crush and mix each med separately. Sure. And pigs fly. And how the heck does room temperature sterile water dissolve meds well enough to get them through without clogging the tube?
When people take them PO they all go down together. Am I supposed to crush each pill separately, too?
Gah.
Blech. I remember having to do that during clinicals, and of course they always found the pt with 10 or more meds so we could have the practice. The instructors told us "You only do it this way for state." But BOY was it tedious.
since giving the meds singly is the usual expectation, it is best to get a doctor's order " may administer all meds together".......of course have to check with pharm for contraindications....
Heh. That works when you're banging out meds in a nursing home. We schedule meds that interact at separate times.
But BOY was it tedious.
GooeyRN, ADN, BSN, CNA, LPN, RN
1,553 Posts
I have always used tap water. It is what we give all of the other patients to swallow their pills with. Should we give everyone sterile water to take their meds and to drink?