Skill 47

Oral Medications

Nasogastric Tube Administration

Nasogastric feeding tubes generally are small-bore tubes that are inserted into the stomach via one of the nares. For long-term enteral feedings, a percutaneous endoscopic gastrostomy (PEG) tube or a jejunostomy tube may be inserted surgically. Do not administer medications into nasogastric tubes that are inserted for decompression.

Preferably, medications administered by enteral tubes should be in liquid form. If a medication is unavailable in liquid form, you will need to prepare an oral medication tablet or capsule by crushing or dissolving it. However, you cannot crush sublingual, sustained-release, chewable, long-acting, or enteric-coated medications. Consult with the hospital pharmacist about whether you can crush or dissolve a medication. Always verify correct placement of a nasogastric tube before administering medications.

Delegation Considerations

The skill of administering medications by enteral feeding tubes cannot be delegated to nursing assistive personnel (NAP). The nurse directs the NAP to:

▪ Keep the patient’s head of the bed elevated a minimum of 30 degrees (preferably 45 degrees) for 1 hour (follow agency policy) after medication administration.

▪ Report immediately to the nurse signs of aspiration such as coughing, choking, gagging, or drooling of liquid or dissolved pills.