The nurse has finished teaching a patient's husband how to ...

[Chelseaamend]

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 statement?
 
  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.

Question 2

A patient at a community health center has been prescribed oral medications and tells the nurse that medications were administered intravenously when the patient was in the hospital.
 
  The nurse discusses the benefits and disadvantages of oral medications, including which facts?
  1. The oral route is considered the second safest route, after the intradermal route.
  2. Tablets that are scored may be crushed for easier swallowing.
  3. Enteric-coated drugs are designed to dissolve in the stomach, not the small intestine.
  4. A major disadvantage of oral medications is that the patient must be conscious and able to swallow.
  5. Enteric-coated drugs should be crushed to help facilitate dissolving by the stomach acid.

[IRincones]

Answer to Question 1

Correct Answer: 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.

Answer to Question 2

Correct Answer: 2,4
Rationale 1: The oral route is considered the safest because the skin barrier is not compromised; if an overdose occurs, drugs remaining in the stomach can be evacuated with stomach contents.
Rationale 2: The purpose of scoring a tablet is the greater ease of cutting the tablet in half or quarters. These same tablets may be crushed, if needed.
Rationale 3: Some drugs irritate the stomach lining and are coated to prevent being dissolved in the stomach. These drugs go on to the small intestine and are dissolved in the alkaline environment.
Rationale 4: This is a major disadvantage of oral medications.
Rationale 5: Enteric-coated drugs are designed specifically to bypass the stomach's acidic environment and continue to the alkaline environment of the small intestine.

[Chelseaamend]

Gracias!

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