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Preparing and Administering Enteric Tube Medications

Panoramica

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

An enteric tube is a tube that is inserted and passed into the stomach or intestines. Enteric tubes serve multiple purposes, including stomach decompression (through the removal of air, gastric contents, and secretions), enteric feeding, and/or the administration of medications or oral contrast. Enteric tubes are indicated for patients with impaired swallowing and for patients with neurological or other conditions associated with an increased risk of aspiration, or when the patient is unable to maintain adequate oral intake of fluid or calories. There are multiple types of enteric tubes, with their generic names assigned according to the insertion site and the gastrointestinal termination point. For instance, one of the common tube types is the nasogastric tube, which is inserted through a nostril and passed along the upper gastrointestinal tract into the stomach.

When administering medications through an enteric tube, it is important to ensure that the tube terminates in the intended gastrointestinal location. When enteric tubes are initially placed, the position of the tube is verified by X-ray. However, due to gastric peristalsis, enteric tubes may migrate out of their intended termination location. Thus, it is important to confirm the appropriate tube location before administering the medications. Medications administered through an enteric tube are typically oral preparations that must either be crushed into powder by the nurse or prepared in suspension or liquid form by the pharmacy. Prior to crushing any oral medications, it is important to confirm that it is appropriate and safe to do so. For example, administering crushed extended-release medications can lead to toxic medication levels, and crushing medications with cytotoxic or carcinogenic properties can harm the healthcare worker. It is also important to consider the tube lumen size when administering medications, because smaller-bore tubes are more likely to become clogged if the medications are not prepared properly or are not flushed with an appropriate amount of fluid.

This video presents the process of assessing enteric tube placement and administering medications through an enteric tube.

Procedura

Preparation

1. Enteral tube medication administration considerations (review in the room, with the patient).

  1. Upon first entering the patient's room, disinfect your hands by washing them with soap and warm water, applying vigorous friction for at least 20 s. Hand sanitizers may be used if the hands are not visibly soiled, but vigorous friction should also be applied.
  2. At the bedside computer, log into the patient's electronic health record and review the pati

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Riferimenti
  1. Potter, P. A., Perry, A. G., Stockert, P. A., Hall A. Essentials for Nursing Practice, Eighth Edition. Elsevier. St. Louis, MO. (2015).
Tags
Enteric Tube Medication AdministrationImpaired SwallowingNeurological ConditionsIncreased Risk Of AspirationOral IntakeEnteric TubeCrushed MedicationsOral PreparationsSuspensionLiquid FormNurseFive RightsSafety CheckpointsGastrointestinal LocationAssessing Enteric Tube PlacementAdministering Medications Through The TubeHand HygieneElectronic Health Record EHRMedical HistoryAllergiesMedication Administration Record MARPatient PreferenceFluid Administration

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