Chapter 6. Non-Parenteral Medication Administration
6.3 Administering Medications by Mouth and Gastric Tube
Administering Medication by Mouth
Medication is usually given orally, which is generally the most comfortable and convenient route for the patient. Medication given orally has a slower onset and a more prolonged, but less potent, effect than medication administered by other routes (Lynn, 2011). Prior to oral administration of medications, ensure that the patient has no contraindications to receiving oral medication, is able to swallow, and is not on gastric suction. If the patient is having difficulty swallowing (dysphagia), some tablets may be crushed using a clean mortar and pestle or pill crusher. Verify that a tablet may be crushed by consulting a drug reference or a pharmacist.
Medications such as enteric-coated (EC) tablets, capsules, and sustained-release (SR) or long-acting (LA) drugs should never be crushed because doing so will affect the intended action of the medication (Lilley et al., 2016). EC medications are designed to be absorbed in the small bowel. Crushing it would cause absorption in the stomach, potentially causing adverse events. SR and LA medications if crushed would result in high doses being absorbed quickly potentially causing adverse events—some of which could be fatal. If medications are able to be crushed and must be in order to allow the patient to swallow them, they should be crushed one at a time and not mixed. This will allow the administrator to tell drugs apart if there is a spill or if the patient refuses some of them. Mixing crushed medications in a small amount of soft food, such as applesauce or pudding may facilitate easier swallowing.
Position the patient in a side-lying or upright position to decrease the risk of aspiration. Offer a glass of water or other oral fluid (that is not contraindicated with the medication) to ease swallowing and improve absorption and dissolution of the medication, taking any fluid restrictions into account. Remain with the patient until all medication has been swallowed. Sign for the medication AFTER the medication has been swallowed / administered.
Checklist 45 outlines the steps for administering medication by mouth.
Checklist 45: Administering Medication by MouthDisclaimer: Always review and follow your agency policy regarding this specific skill. |
|||
Safety considerations:
|
|||
Steps |
Additional Information |
||
| 1. Perform hand hygiene before medication preparation.
Check MAR to guide you to which medications you are preparing. Follow agency policy to ensure MARs are accurate and verified appropriately. |
An MAR that is checked by more than one healthcare professional provides a very reliable record for administering medications. Agencies may vary in relation to MAR verification processes. |
||
2 a. As you are removing medications from the dispensing system, perform the SEVEN rights three times with each individual medication: (single dose packaging is not opene