Policy Manual sample

MDT Home Health Care Agency, Inc. 75 MEDICATION ADMINISTRATION NASOGASTRIC OR GASTROINTESTINAL PURPOSE: Prescribed medications may be administered via nasogastric or gastrointestinal tube as needed and in accordance with prescribing information. Care should be taken to verify that any medication that must be crushed may be crushed. If the tube is permanent, the nurse should work with the patient, family and pharmacist to obtain liquid medications. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: • Graduated medicine cups for measuring liquid medications • Suitable substitute for crushing medications • Administration syringe with tip compatible with enteral tube connector • Medications • Water GENERAL CONSIDERATIONS: 1. As with oral medication, verify the compatibility with each other and with feeding components. Some commonly given drugs that are incompatible with some enteral feeding include: • Dimetane elixir • Mellaril oral solution • Robitussin expectorant • Thorazine concentrate • Sudafed syrup • Mandelamine suspension • Cibalith-S syrup • Feosol elixir • Klorvess syrup • Potassium chloride liquid • Medium chain triglyceride (MCT) oil • Dilantin suspension • Neo-calglucon syrup • Lanoxin elixir 2. Obtain liquid forms and dose-volume equivalents as able by physician orders. Discuss with the physician the substitution of drugs with like products available in liquid, chewable or injectable forms. All solid medications must be finely crushed; chewable forms may be easier to crush. 3. Note the volume-required compatibility with fluid requirements or restrictions. 4. Ensure clear labeling of suspensions that require thorough shaking to deliver an accurate dose. 5. Do not instill any capsule or particles of capsules into an enteral tube. 6. Avoid thickened solutions, fiber or bulk formers because these expand in liquid and may obstruct tubes quickly. 7. Use enteric-coated tablets with precaution and physician awareness. Destroying the coating by crushing may affect patient tolerance of the drug.