Nasogastric, Orogastric, Or Gastrostomy administration

    • Nasogastric, Orogastric, Or Gastrostomy administration
      • In children
        • Use elixir or suspension (rather than tablet) preparations of medication whenever possible.
        • Dilute viscous medication or syrup with a small amount of water if possible.
        • If administering tablets, crush tablet to a fine powder and dissolve drug in a small amount of warm water.
        • Never crush enteric-coated or sustained-release tablets or capsules.
        • Avoid oily medications because they tend to cling to side of tube.
        • Do not mix medication with enteral formula unless fluid is restricted. If adding a drug:
          • Check with pharmacist for compatibility.
          • Shake formula well, and observe for any physical reaction (e.g., separation, precipitation).
          • Label formula container with name of medication, dosage, date, and time infusion started
        • Check for correct placement of nasogastric (NG) or orogastric (OG) tube
        • Attach syringe (with adaptable tip but without plunger) to tube.
        • Pour medication into syringe.
        • Unclamp tube, and allow medication to flow by gravity.
        • Adjust height of container to achieve desired flow rate (e.g., increase height for faster flow).
        • As soon as syringe is empty, pour in water to flush tubing.
          • Amount of water depends on length and gauge of tubing.
          • Determine amount before administering any medication by using a syringe to fill completely an unused NG or OG tube with water. Amount of flush solution is usually 1.5 times this volume.
          • With certain drug preparations (e.g., suspensions), more fluid may be needed.
        • If administering more than one drug at the same time, flush tube between each medication with clear water.
        • Clamp tube after flushing unless tube is left open.
      • Advantages
        • Ability to administer medications around the clock without disturbing the child
      • Disadvantages
        • Occlusion, clogging
        • Adequate flushing

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