sng-tubesyringeprocedure

Administering Medication through Gastrostomy Tube via Syringe Things to consider: • Be sure to take steps to ensure patient privacy when performing 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/she is able to help the student learn self-care skills Supplies: Prescribed medication Syringe/s Measuring cups Extension set, if applicable Warm tap water, if prescribed Towel or wash cloth Non-sterile gloves Student’s Individualized Health Plan (IHP) and/or healthcare provider’s order Procedure: 1. Check for authorization forms/record a. Medication Administration Form b. Medical provider c. Parent/guardian 2. Check for the Five Rights a. Right student b. Correct time c. The medicine container matches authorization forms and medication administration record d. The dose on medication container matches authorization form and records e. The medication is in the correct route as identified on medication container, authorization forms and medication record 3. Ensure that the medication has not expired 4. Explain the procedure to the student at his/her level of understanding 5. Wash hands 6. Gather equipment and place on clean surface 7. Position child either sitting or supine with head up at least 30 degrees a. 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 8. Put a towel or washcloth under student’s gastrostomy tube 9. Put on gloves 10. 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

a. Compare external tube length to tube length measurements obtained after initial placement of the tube, contact parents/guardian and healthcare provider if discrepancy in measurements b. If student has abdominal distention do not administer the medication, instead contact parent/guardian and healthcare provider 11. Measure the medication and water in separate measuring device, i.e. cup 12. Draw up medication in syringe 13. Fill the extension tubing with water using a syringe with at least 5 cc or ml of water 14. Open port on the gastrostomy access port 15. Attach the extension tube filled with water to the access port 16. Open medication port on the extension tube and insert syringe with medication 17. Slowly push the plunger into barrel of syringe instilling all the medication into the tube 18. Close clamp extension tube 19. Detach the syringe from the extension tubing 20. Draw up prescribed water into syringe and attach the extension tubing 21. Open clamp 22. Gently and slowly push the water into tubing until all water has gone into the tube 23. Re-clamp extension tubing 24. Detach syringe and cap access port 25. Secure medication 26. Wash syringe and extension tubing with soap and warm water and put in home container a. Check with your school nurse about the length of time to reuse any of the equipment 27. Remove gloves 28. Wash hands 29. Document medication administration on medication administration record 30. Follow up with parents/guardian and healthcare provider, as needed Resources: MIC—KEY LOW--PROFIILE GASTROSTOMY FEEDING TUBE: YOUR GUIDE TO PROPER CARE http://www.mic-key.com/media/40679/r8201b_mic-key_care_guide_english.pdf MIC Enteral Feeding Tubes and Accessories http://www.kchealthcare.com/media/2886710/u4850_mic_enteral_tubes.pdf Guidance and support to help you manage your gastrostomy tube (g-tube) Capsule Non-Balloon Mini ONE® Buttons http://www.amtinnovation.com/pdf/AMT_NonBalloonPatientCare.pdf References: Bowden, V. R., & Greenberg, C. S. (2012). Pediatric nursing procedures (Third Edition). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Connecticut State Department of Education.