The nurse has finished teaching a patient's husband how to administer drugs and enteral feeding through a gastrostomy tube. The nurse knows the husband understands the use of the tube when he makes which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply

Question

1. "My wife has a gastrostomy tube instead of a nasogastric tube because she will have the tube for a long time."
2. "I will need to use liquid medications. If any of the medications are in pill form, I will use the pill crusher to crush them and mix them with water before putting them in the tube."
3. "This medication says it is enteric coated. I'm not supposed to crush this kind of medication. I will need to ask the doctor to substitute another medication that is liquid or can be crushed."
4. "There's a big difference in how the drugs work in the body when they're taken orally and when they're administered through the tube. That's why my wife has to have this tube."
5. "I have to be very careful to flush the tube after I put medication in it. If I don't, the tube could get clogged."

Answer 1

1,2,3,5
Rationale 1: Nasogastric tubes are used for short-term care while gastrostomy tubes are placed in patients who will need long-term care.
Rationale 2: Most health care providers order drugs in liquid form for NG and G tube patients. If a medication does not come in liquid form, the solid form will need to be crushed and mixed with water prior to administration unless there is a contraindication for crushing the medication.
Rationale 3: Enteric-coated medications should not be crushed. To do so would expose the drug to the acid in the stomach when it is intended to bypass the stomach acid and be dissolved in the alkaline environment of the small intestine.
Rationale 4: Drugs administered via gastrostomy tube are affected by the same physiological processes as those given orally.
Rationale 5: While solid drugs may be crushed and dissolved in water prior to being administered, they tend to clog the tubes if the tubes are not routinely flushed.
Global Rationale: Nasogastric tubes are used for short-term care while gastrostomy tubes are placed in patients who will need long-term care. Most health care providers order drugs in liquid form for NG and G tube patients. If a medication does not come in liquid form, the solid form will need to be crushed and mixed with water prior to administration unless there is a contraindication for crushing the medication. Enteric-coated medications should not be crushed. To do so would expose the drug to the acid in the stomach when it is intended to bypass the stomach acid and be dissolved in the alkaline environment of the small intestine. While solid drugs may be crushed and dissolved in water prior to being administered, they tend to clog the tubes if the tubes are not routinely flushed. Drugs administered via gastrostomy tube are affected by the same physiological processes as those given orally.