A client with dysphagia receives continuous enteral feedings via a nasogastric (NG) tube. The healthcare provider has ordered two distinct liquid medications to be given via the tube. After pausing the feeding pump, in what sequence should the practical nurse (PN) execute the following actions to safely deliver these medications?
- 1Elevate the head of the client's bed to at least 30 degrees.
- 2Aspirate gastric contents to verify correct tube placement by checking the pH and assess residual volume.
- 3Attach a large-barrel syringe without the plunger to the tube and flush with 30 mL of sterile water.
- 4Pour the first liquid medication into the syringe barrel, allowing it to flow in by gravity.
- 5Flush the nasogastric tube with 15 to 30 mL of sterile water.
- 6Administer the second liquid medication and conclude with a final flush of 30 to 60 mL of sterile water.
Answer
The correct sequence begins with positioning the client, verifying tube placement, performing an initial water flush, administering the first medication via gravity, performing an intermediate flush, and finally administering the second medication followed by a terminal flush.
Safe administration of medications via an enteral tube requires strict adherence to sequential safety checks. Elevating the head of the bed minimizes aspiration risk. Verifying placement ensures the tube has not migrated to the lungs. Flushing before, between, and after medications verifies patency, prevents drug-nutrient/drug-drug incompatibilities, and ensures the full dose reaches the stomach. Gravity administration prevents excessive pressure that could rupture the tube.
Step-by-Step Solution
Key Concept
Safe administration of enteral medications