Administration of Medication through Nasogastric Tube

Subject: Fundamentals of Nursing

Overview

Administration of Medication through Nasogastric Tube

The patients who have a nasogastric (NG) tube in place are commonly given medications through the tube. If a medication is not available in liquid form, we must first crush it or open the capsule and empty the powder or granules and then dissolve the medication in a facility- approved-fluid.

Purpose

  • To provide medications to the patients who are unable to take through the oral route.

Articles

  • All articles required for tube feeding
  • Medications to be administered
  • Mortar and pestle if tablets are used

Procedure

S.N. Nursing Action Nursing
1 Identify the patient's name and verify medication order.

Ensures the correct administration of medication.

2  Explain the purpose of medication to the patient and allow the patient to clarify doubts. Explanation encourages cooperation and reduces anxiety.
3 Assess the patient's ability and any contraindication e.g. NPO state. Proper assessment will help in determine condition of the patient.
4

Check medication card/form with the physician's written order for accuracy, completeness etc. 

Check the patient's name, name of drug, dose, route and time of administration.

 Physician's order is the most legal source of information and eliminates medication error.
5 Wash hands and wear gloves if needed. Reduces spread of microorganisms.
6 Prepare needed articles and arrange in bed side. Facilitate orderly performance of procedure and save the times.
7 Take appropriate medication from the stock or tray and compare the label of medication with cardex, check expiry date, dose, route, indication and contraindication. Reduces the chance of error.
8 Calculate correct drug dose. Perform 2nd check before preparing medicine. Provides accurate dose.
9 If tablets are to be administered, crush it into fine powder and mix it in sufficient amount of water. Large tablets are difficult to dissolve.
10

Return the drug container back to the cupboard after checking the label.

 3rd check of level reduces errors.
11 Identify the patient by comparing name on card with the name the patient gives when asked. Reduces risk of error.
12 Perform necessary pre-administration assessment for specific medication. Gives information as to whether medications should be given at that time.
13 Place a mackintosh and towel over the chest. Protects the patientand bed linen from soiling.
14 Place the patient in high Fowler's position and verify the placement of the tube in the stomach. Fowler's position enhances gravitational flow of feed through tube and prevents risk of aspiration.
15 If placement of tube is correct, flush the tube with 15-30 ml water (adults) and 5-10 ml (children) before giving the medication. Ensures patency of tube.
16 Administer the prepared medication in the same manner as feeding is administered. Administered each medication separately and flush with 5 ml of water after each. If the patient is receiving a continuous feeding, do not mix the medications in the enteral feeding solution.  
17 After administering medication, flush the tubing with at least 10 to 30 ml of a facility-approved fluid to keep an NG tube from becoming occluded. Prevents clogging of medic tube.
18 Observe the patient for any adverse reactions.  
19 Assist the patient to a comfortable position. Maintains comfort.
20

Replace articles and returns medication cards to appropriate files.

Dispose of soiled supplied and wash hands. Clean work area.

 Loss of record can lead to errors in administration.
21

Record the medication administration with date, time and signature.

Record and report any reaction observed after the administration of the drug to the ward sister and doctor.

 Prompt documentation prevents errors such as repeated doses.
22 Observe the patientfor 30 minutes to evaluate effectiveness of medication and observe the patient for any adverse reactions. Helps to identify the therapeutic effects and detecting side effect.
Things to remember

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