Administering medication through gastrostomy tube via gravity.
Things to consider.
Be sure to take steps to ensure patient privacy when performing the procedure.
The most significant risk with giving liquids
via a gastrostomy tube is possible aspiration into the lungs.
Be sure the student is positioned properly
with head elevated at least 30 degrees.
Encourage the student to assist in the procedure
as much as he or she is able to help the student learn self-care skills.
Procedure for medication administration.
Check for authorization forms or record.
Review the medication administration form,
the medical provider form, and the parent or guardian consent form.
Check for the five rights -- right student, correct time,
the medicine container matches authorization forms
and medication administration record,
the dose on medication container matches authorization form and records,
the medication is in the correct route as identified on medication container,
authorization forms, and medication record.
Ensure that the medication has not expired.
Explain the procedure to the student at his or her level of understanding.
Wash hands.
Gather equipment and place on a clean surface.
Position child either sitting or supine with head up at least 30 degrees.
The most significant risk with giving liquids
via a gastrostomy tube is possible aspiration into the lungs.
Be sure the student is positioned properly
with head elevated at least 30 degrees.
Put on gloves.
Put a towel or washcloth under the student’s gastrostomy tube.
Observe abdomen for signs of malposition
or obstruction of gastrostomy tube, such as difference in external tube length
compared to baseline measurements or abdominal distention.
Compare external tube length to tube length measurements
obtained after initial placement of the tube.
Contact parents or guardian and healthcare provider
if there is a discrepancy in measurements.
If student has abdominal distention, do not administer the medication.
Instead, contact parent or guardian and healthcare provider.
Fill the extension tubing with water using a syringe
with at least 5 cc or milliliters of water.
Remove plunger from syringe.
Open port on the gastrostomy access port.
Attach the extension tube filled with water to the access port.
Attach syringe to the medication port on the extension tube.
Pour prescribed medication amount into syringe.
Elevate the syringe above the level of the stomach.
Open clamp on extension tubing and allow medication
to slowly flow through extension tubing.
Close clamp on extension tube.
Pour prescribed amount of water into syringe.
Open clamp and allow water to slowly flow through extension tubing.
Clamp enteral tube and remove syringe.
Remove extension tubing and replace plug on gastrostomy tube.
Secure medication.
Wash syringe and extension tubing with soap and warm water
and put in home container.
Check with your school nurse about the length of time
to re-use any of the equipment.
Remove gloves. Wash hands.
Document medication administration on medication administration record.
Follow up with parents or guardian and healthcare provider as needed.