PEG- Med Admin

Equipment:

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• Medication Administration Record (MAR)
• 60 mL catheter-tip syringe
• pH strips
• Graduated container
• Medication
• Med cups
• Pill crusher
• Water
• Straw
• Clean gloves
• Stethoscope
• Pulse ox
• Scissors

Steps:

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1. WIIAPA:
   1. Wash hands
   2. Introduce self
   3. Identify patient (use 2 identifiers)
   4. Allergies – don’t forget food allergies
   5. Plan of care
   6. Assess patient

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• Verify Order with MAR. Remember 7 rights of med administration.
• Review pertinent medication information – ex: onset, action, side effects, labs or vital signs to monitor.
• Prepare Medication:
  1. Perform hand hygiene.
  2. Fill graduated container with 50 – 100 mL of water.
  3. If preparing more than 1 medication, label med cup with name/dose.
  4. Crush medication into fine powder using pill crusher. Place into med cup.
  5. Dissolve each medication individually with 30 mL water, stirring with straw if needed.
• Enter patient’s room. Verify name, DOB, and allergies.
• Educate patient:
  1. Explain procedure.
  2. Medications – purpose, action, side effects.
• Place patient in high fowlers position or elevate HOB at least 30°. Preferably 45°.
• Hand hygiene. Apply clean gloves.
• Verify tube placement:
  1. Auscultate for presence of bowel sounds.
  2. Attach syringe and aspirate 5 ml gastric content and check pH (less than 5.0= good indicator tip of tube is in stomach).
• Check Gastric Residual Volume:
  1. Draw up 10-30 mL of air and inject air slowly into tube.
  2. Pull back slowly and aspirate total amount of gastric contents.
  3. Return to stomach unless content exceeds 250 mL.
  4. If GRV is excessive, hold medication and notify provider.
• Flush tubing with 30 mL of water.
  1. Pinch/clamp tube and remove syringe.
  2. Draw up 30 ml of water into syringe.
  3. Reconnect syringe to tube, release clamp, and flush tubing with water.
  4. Pinch/clamp tube again and remove syringe.
• Administer medications:
  1. Remove plunger from syringe and reinsert syringe into tube.
  2. Administer medication by pouring into syringe – allow to flow by gravity.
  3. Between each medication, flush with 15 – 30 mL of water.
• Flush tubing with 30 – 60 mL of water after last medication is given.
• Clamp tube and replace plug/cap at end of tube.
• Keep HOB elevated x 1 hour.
• Dispose of supplies and clean patient area.
• Remove and dispose of gloves. Hand Hygiene.
• Monitor patient / Evaluate medication effectiveness within 30 minutes.
• Document – ex: Placement check, GRV, pH of aspirate, medications administered, response to medication, patient teaching, etc.