Transcript AdministertingMedsthrutubes

ADMINISTRATION OF
MEDICATION THROUGH
TUBES
NUR 104
Module F
GASTROINTESTINAL TUBES
 Nasogastric (NG) tube—used to intubate the
stomach by way of the nasal passages
 Gastrostomy tube—placed through a surgical
incision in the stomach
 Jejunostomy tube—placed surgically into the
jejunum
Nasogastric Tube
 Used in patients with impaired swallowing,
who are comatose, or have a disorder of the
esophagus
 Use the liquid form of the medication when
possible
 Can crush tablet or pull capsule apart and
mix with water
 DO NOT crush or open enteric-coated or
delayed release capsules
Continued…
Procedure for administering
medications
 Assemble all needed equipment
 Follow the 6 Rights of Drug Administration:
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Right Drug
Right Time
Right Dose
Right Patient
Right Route
Right Documentation
Equipment Needed…
 Glass of water
 60cc catheter tip
syringe
 Stethoscope
 Medication profile
 Gloves
Technique
 Check medication profile for correct patient,
medication, dosage, route, and time
 Verify patient’s ID by bracelet
 Explain what you will be doing to the patient
 Verify placement of tube before administering
any liquids
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Method 1—Put on gloves and place
stethoscope over the stomach; using catheter
tip syringe, insert 10cc of air into the NG tube
and listen for a gurgling sound; withdraw the
amount of air inserted
Continued…
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Method 2—Put on
gloves and unclamp
the NG tube; place
tube next to your ear
and listen for gurgling
timed with respirations;
if heard, tube is
probably in the lungs
and should be
removed and
reinserted
 Once placement has
been verified, clamp
tubing and attach
syringe; pour the
medication into the
syringe and unclamp
the tubing; allow the
medication to run in by
gravity
Continued…
 Reclamp the tubing and
add approximately 50cc
of water; unclamp and
allow the water to run in
by gravity; reclamp the
tube as soon as the
water has gone in
 DO NOT ATTACH THE
NG TUBE TO
SUCTION FOR AT
LEAST 30 MINUTES
AFTER GIVING
MEDICATIONS
 Provide oral hygiene
 Record all water as
intake
Gastrostomy Tube
Jejunostomy Tube
Placement Verification of G-tube and
J-tube
 Put on gloves and clamp tubing
 Attach 60cc syringe to tubing and aspirate
stomach contents
 Notify MD if residual (amount aspirated) is
greater than 100cc
 Re-instill aspirate
 Flush with 30cc water
 Administer medication as with NG tube
Rectal Suppositories
 Suppositories dissolve at body temperature
 Should be stored in a cool place to prevent
softening
 Should not be used for patients who have
had recent prostate or rectal surgery or
trauma
Administration of Rectal Suppositories
 Assemble medication and wash hands
 Follow the 6 Rights of Drug Administration
 Verify patient’s identification and explain
procedure
 If possible, have patient defecate prior to
administration
 Place patient on left side in Sim’s position
 Put on gloves
Continued…
 Open the suppository and apply water-
soluble lubricant
 Place the tip of the suppository at the anus
and ask patient to take deep breath in and
out
 Insert the suppository approximately 1 inch
 Keep patient on side for 15-20 minutes to
allow for absorption of the medication
 Remove gloves and wash hands
Continuous Bladder Irrigations
 Continuous infusion of a sterile solution into
the bladder
 Usually a triple-lumen catheter—1 inflates
balloon, 1 irrigates, and 1 drains
 Usually following genitourinary surgery to
keep bladder clear and free from blood clots
and sediment
Continued…
Continued…
 MD will order solution, strength, and flow rate
 Label the bag “GU IRRIGATION ONLY”
 Spike bag with irrigation tubing using aseptic
technique
 Close clamp on tubing and fill chamber half
full with fluid, unclamp tubing and fill to
remove all air, and close clamp
 Clean port with antiseptic swab
Continued…
 Calculate drip rate and adjust roller clamp
 Observe intake and output
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If intake continues to be greater than output,
the catheter may be blocked by a blood clot—
over-distention can result in discomfort,
bladder damage, or rupture
Vaginal Irrigations
 Douche
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Not necessary for normal hygiene but may be
required if a vaginal infection and discharge
are present
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Not an effective method of birth control
Continued…
 Procedure
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Wash hands
Follow 6 Rights of Drug Administration
Provide privacy
Explain the procedure
Put on gloves
Ask patient to void and place on the bedpan
Hang bag of solution on IV pole approximately
12 inches above vagina
Continued…
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Apply water-soluble lubricant to plastic vaginal
tip
Cleanse the vulva by allowing a small amount
of the solution to flow over
Gently insert the nozzle directing it down and
back 2-3 inches
Hold labia together to facilitate filling the
vagina
Rotate the nozzle to irrigate all parts
Intermittently release the labia to allow
solution to flow out
Continued…
Continued…
 After all of the solution has infused, have
patient sit up and lean forward to thoroughly
empty the vagina
 Dry external area
 Discard equipment and wash hands