Enteral Administration Chapter 9 Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc.,...

Enteral Administration

Chapter 9Chapter 9

Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Chapter 9

Lesson 9.1


ObjectivesObjectives

• Correctly define and identify oral dose forms of medications

• Identify common delivery systems used to administer oral medications

• Describe general principles of administering solid forms of medications and the different techniques used with a medication card, computer-controlled, and unit dose distribution systems

• Compare techniques used to administer liquid forms of oral medication using the medication card and unit dose systems of distribution


Administration of Oral MedicationsAdministration of Oral Medications

• Capsules – small, cylindrical gelatin containers used to administer unpleasant-tasting medications Timed-release capsules – provide gradual and

continuous release of a drug• Lozenges, troches – flat disks in a flavored base• Tablets – powdered drugs that have been

compressed• Orally-disintegrating tablets – rapidly dissolve on

tongue within seconds• Elixirs – drugs dissolved in water and alcohol• Liquid suspensions, syrups


Administration of Oral Medications Administration of Oral Medications (cont’d)(cont’d)

• Common methods used to administer oral medications Unit dose packaging – provides a single dose Soufflé cups Medicine cups Medicine droppers Teaspoons Oral syringes – plastic syringes calibrated and

used to measure liquid medications Nipples with additional holes – used for infants


Administration of Solid-Form Administration of Solid-Form Oral MedicationsOral Medications

• Two techniques for administering medications Medication card Unit dose distribution

• Perform premedication assessment in all cases• All techniques follow the six rights

RIGHT patient RIGHT drug RIGHT route RIGHT dose RIGHT time RIGHT documentation


Administration of Solid-Form Administration of Solid-Form Oral Medications (cont’d)Oral Medications (cont’d)

• General principles apply to all distribution systems Give the most important medications first Do not touch the medication with your hands Encourage liquid intake to ensure swallowing Remain with patient while medication is taken;

DO NOT leave the medication at bedside unless an order to do so exists

Discard the medication container

• Provide complete documentation of administration and responses to therapy


Administration of Solid-Form Administration of Solid-Form Oral Medications (cont’d)Oral Medications (cont’d)

• Chart date, time, drug name, dosage, and route of administration

• Regularly record patient assessments to evaluate therapeutic effectiveness

• Chart and report any sign of adverse effects

• Perform and validate essential education about drug therapy and other aspects of intervention for the individual


Administration of Liquid-Form Administration of Liquid-Form Oral MedicationsOral Medications

• General procedures are the same as with solid-form oral medications

• Perform premedication assessment in all cases• Liquid medications are most commonly given to

infants using a syringe or dropper• Place the syringe between the cheek and gums,

halfway back into the mouth, and slowly inject medication to allow the infant to swallow


Administration of Liquid-Form Administration of Liquid-Form Oral Medications (cont’d)Oral Medications (cont’d)

• General principles for infants, children, and adults Give adults and children the most important

medications first NEVER dilute medications without specific

orders. DO NOT leave a medication at the bedside without an order to do so

Check an infant’s ID and be certain the infant is alert



Administration of Liquid-Form Administration of Liquid-Form Oral Medications (cont’d)Oral Medications (cont’d)

• Measuring techniques vary according to receptacle used

• Measuring cup Cover label to prevent smearing; place

fingernail at exact level on measuring cup; read the volume at the level of meniscus

• Oral syringe Select syringe of appropriate size. Draw up

prescribed volume of medication from bottle or medicine cup


Chapter 9

Lesson 9.2


ObjectivesObjectives

• Cite the equipment needed, techniques used, and precautions necessary when administering medications via a nasogastric tube

• Meet the person’s basic metabolic requirements and provide adequate nutritional intake through the use of enteral nutrition support

• Cite the equipment needed and technique required to administer rectal suppositories

• Cite the equipment needed and technique used to administer a disposable enema


Administration of Medications Administration of Medications by Nasogastric Tubeby Nasogastric Tube

• Drugs are administered via nasogastric tube for specific patients, using a liquid form whenever possible.

• Remember: Always flush the tube before and after

administration with 30 mL of water Perform premedication assessment Assemble equipment before administration Flush between each medication with

5 to 10 mL of water


Administration of Medications Administration of Medications by Nasogastric Tube (cont’d)by Nasogastric Tube (cont’d)

• Prepare doses as for administration of solid- or liquid-form oral medications

• Check nasogastric tube placement• Follow procedure for administering

medication • DO NOT attach suction for 30+ minutes• Provide complete documentation of

administration and responses to therapy


Administration of Enteral Feedings via Administration of Enteral Feedings via Gastrostomy of Jejunostomy TubeGastrostomy of Jejunostomy Tube

• Enteral formulas are designed to provide basic metabolic requirements and adequate nutritional intake

• Prescribed enteral formula should be checked• Formula should be fully labeled • Discard unused formula every 24 hours• Follow the guidelines specific for patients

receiving general nutrition via intermittent or continuous feedings


Administration of Enteral Feedings via Administration of Enteral Feedings via Gastrostomy or Jejunostomy Tube (cont’d)Gastrostomy or Jejunostomy Tube (cont’d)

• Verify tube placement and initiate feeding• Flush with 30 mL water, then clamp tube• Proceed with tube feeding technique

Intermittent: use Toomey syringe Continuous: use disposable feeding container

and enough formula for a 4-hour period

• Check gastric residual volume before next feeding; listen for bowel sounds



Administration of Rectal Administration of Rectal SuppositoriesSuppositories

• Suppositories are solid medication designed to dissolve inside a body orifice

• Equipment is simple Finger cot or disposable glove Water-soluble lubricant Prescribed suppository

• Perform standard premedication assessment


Administration of a Disposable Administration of a Disposable EnemaEnema

• The dose form will be a prepackaged, disposable-type enema solution

• Technique begins with the six rights Explain procedure and check pertinent

parameters• Time of last defecation

Position patient on left side Apply lubricant to rectal tube Insert lubricated tube and insert solution.


Enteral Administration Chapter 9 Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc.,...

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