Nursing Demos: Administration of Medication via Percutaneous Endoscopic Gastrostomy Tube


Hi. I’m Sarah and today we’re going to do
g-tube medication administration. So we’re going to verify that we have our
patient’s chart and our physicians order. Okay. So we have Jamie Jones MRN number 5891351329, date of birth 1/16/62 and we want to verify that the patient has no known allergies. So today
we’re going to do the medication administration. So again, I’m going to
compare the MAR with the physician orders. I have Jamie Jones MR 5891351329, date of birth 1/16/62. The patient has no known allergies. The patient is
currently NPO with medications per g-tube. I see today that the patient has
morning medications due at 10:00 a.m. I’m going to now take my MAR and go to
the med cart and prepare medications to administer to the patient. Now I’m going
to do my hand hygiene. Okay. So we’re going to perform our first
check. Grab the patient medications here. I see this is Jamie Jones. Date of birth
1/16/62 MRN number 5891351329 Okay. I see here I have potassium elixir 20 meq daily per g-tube. Potassium chloride 20 meq / 30ml. Expiration date 12/20/50. So we’re good. Next medication erythromycin 250
capsule every six hours per g-tube. Due at 10 a.m. Erythromycin here, 250 capsule, every six
hours and I’m going to give this per g-tube. Next medication: Lopressor. 50
milligrams per G tube twice daily due today at 10 AM. Medication Lopressor 50 milligram tablet. And that is it for our g-tube meds. So now,
I’m going to perform my second check. Again, I have Erythromycin 250 milligram
capsule, every six hours per G-tube due at 10 AM. Again, Lopressor 50 milligrams per G tube, twice daily, due today at 10 a.m. And potassium chloride elixir 20 mil equivalents per daily, per G tube due today at 10 a.m.
Expiration date of 12/20/50. And I also check the expiration date on my other
medications and they are good to go. So now I’m going to prepare my
medications. So I’ve completed now my first and second check along with my six
rights. I will complete the documentation after I have administered the meds. I’m going to donut my gloves. Okay.
My first medication is the potassium elixir. I’m going to grab a med cup here,
20 meq. So it says here on the bottle 20 meq’s per 30 ml. So that means I’m going to
need 30 ml of this solution. Now each of your medications should have a separate medication cup. So now I’m going to measure this out. Okay. That’s my potassium 30, er, 20 meq with 30 ml. Okay. My next medication is
erythromycin 250 capsule. Since this is a capsule we can’t crush it, but we’re going to go ahead and open the capsule. Put the powder inside of the med cup,
here, and open this capsule. And prior to doing all this, I did check all my medications. I know the reason and the side effects and any nursing
implications that I might need to be concerned about prior to administering
the medication. Patient’s vitals were stable and labs were good for the morning. Okay, that’s my erythromycin. Next, I have the lopressor 50 milligrams
for the g-tube. This medication, since it’s a tablet, I’m going to have to crush. So you want to make sure that your pill crusher is clean, which it is, and then
I’m going to have to clean it after use. I’m going to put the 50 milligram tablet
in there. I’m going to crush it. Okay, the other option would to
be to use a silent nigh,t here. I’ve got my medication all crushed. I’m gonna put it in its med cup. Gotta get it all in there. And then we need to make
sure we clean it after we use it. So we’re gonna grab an alcohol wipe, here. And I’m going to clean it. So
when the next person comes to use it, it’s all ready to go. Now, I’m going to
dilute my medications with about 15 ml’s. Okay. I need to grab my piston and the
container we’re going to put our medications here on the tray. We’re going to go to the patient’s room. I also I’m going to grab a tongue
depressor. For my hand hygiene. Okay, now we’re about to enter the
patient’s room. Knock knock knock. Hi, Mr. Jones it’s Sarah again. I’m here to
administer your medications. How you doing? Any pain? Okay, good. I’m performing my hand hygiene. I’m going to don my gloves. Then we want to make
sure that the patient is positioned at a 45 to 90 degree angle. How’s that? Is that okay for you? And then
I’m gonna bring it up to a comfortable height for me. Okay, Mr. Jones, can you
verify your name and date of birth for me? Jamie Jones we have here MR 589135132 and date of birth, you said is 1/16/62. Great, okay. Any pain or
abdominal discomfort? No? Okay, good. I’m just gonna take a quick listen here. Now, we’re going to check for tube
placement. So we want to drop about 30 milliliters of air. Okay we’re gonna put the tube into the patient’s tube. Or the piston into the patient’s tube. Place the
stethoscope over the patient I’m gonna instill the air. Listen for a swishing
sound. Okay. Sounds like placement’s good. Now we want to aspirate for any content. Anything less than 250 can be instilled
back into the patient. Remove my piston here. I’m going to close up the g-tube so nothing leaks out. Now we’re gonna get ready to administer
a med. So let’s make sure everything is fully diluted. Mix everything up here. So
here’s our lopressor. This is for your heart. I verified that your vitals are stable. So it’s okay to give your erythromycin, that’s here. That’s an
antibiotic. And your potassium. Your potassium was a little low today so we’re gonna give you some of that, okay? All right. And that’s already diluted in
a liquid form. Now I’m going to take the piston out again. I’m going to take the plunger out. We’re going to put the syringe back into the patient’s g-tube here. We’re going to administer about a 15 milliliter flush. I made sure that I have enough water in the graduate. For each flush. Okay. So there’s about 15 ml. Okay. Flush. Make sure there’s no clogs or anything. Now we’re going to administer medication. So first, here I have the lopressor and
after each medication you’re going to flush as well. So another 15 ml of flush. Here’s some water. Okay. Good. Let that clear. Then, our next medication, the antibiotic. Okay. And another 15 ml flush. And lastly, the potassium. And last, you’re going to do a 15 to 30 ml flush after the last medication. And remove
the piston. Close up the g-tube. Okay, Mr. Jones I’ve given you all your
medications. Anything else I can do for you right now? Put my side rail back up. The patient has its call light. I’m going to lower the bed. Remove my gloves before my hand hygiene. Okay, Mr. Jones I’m gonna go document what I did right now. You let me know if you need anything. I’ll be back in about an hour to check on you. Now I’m back at
the nurse’s station. I’m going to document. We want a document the right patient, right medication, right dose right route, right time, and correct
documentation. I also want to document how much fluid I gave the patient during the
medication administration and that he tolerated the procedure while. I also resumed tube feedings prior to leaving the room per the physician orders. And that concludes our g-tube medication administration scale for the day.