provide privacy, lubricate tip, position client in side-lying or Sim's position, insert suppository past internal sphincter about 3 inches, instruct client to retain for at least 20 minutes Rectal Medication Considerations

1. Medication Administration via the
Gastrointestinal (GI) Route
Information in this presentation refers to Knowledge Objective II in your
module syllabus:
At the completion of this module, nursing students will be able to
differentiate between the routes and methods of medication
administration using the six rights and three checks during case
scenarios and simulation in the lab setting with 100% accuracy using
a predetermined rubric.
See next slide for presentation specific objectives

2. Presentation Objectives
Upon completion of this presentation, the
learner should be able to:
• List essential guidelines for administering
medications via gastrointestinal (GI) route.
• Identify essential information to be given to
the client about her/his medication.
• Outline the general procedure for
administering medications via GI route.

3. A medication is generally prepared for one or
more routes of administration. This unit will
focus on the GI routes:
• Oral
• Sublingual
• Buccal
• Rectal
Comment on routes of administration

4. Oral Route
• Most common form
of drug
administration
• Always keep in mind
the six rights and
three checks
• Practice infection
control: wash hands
before setting up
and between clients

5. General procedures for oral administration:
• Identify the medication order, use hospital policy when
checking medication orders
• Wash your hands and prepare the medication
• Identify your client and explain the medications to be given
• Take the required assessment measures (B/P, apical pulse, etc)
• Assist the client to take the medications
• Stay with the client until all medications have been taken
• Document the medication administration
• Evaluate the effects of the medication
• Report any undesired responses or side effects
Oral Route

6. Check the orders
on MAR

7. Wash your hands
Identify your client:
Ask them their name and DOB
Verify id on client arm band

8. Perform required assessments:
B/P, apical pulse, etc
Document results

9. Assist client to take meds
Document meds given

10. Important: let your client know as much as
possible about the medications they are taking
• Give the name of the medication
• Explain what is being given for (in common language)
• What effects are expected; explain possible adverse effects
• Discuss reasons for why medications are scheduled the way
they are, for example:
– With meals or on an empty stomach
– Whether or not certain foods will affect the medication
– The reason the medication is scheduled at regular intervals
• Explain medications that cannot be chewed or crushed (i.e.,
coated tablets) and to drink plenty of water with enteric
coated pills and capsules to help dissolve
Oral Route, con’t

11. When the client is planning to go home:
• Be specific with instructions on how to take and work out a
schedule that fits around the client’s home routine
• Instruct the client on what to do if a dose is missed
• Emphasize the importance of not discontinuing the
medication without consulting his/her doctor
• Emphasize the importance of not sharing medications with
others who may have similar symptoms
• Write the instructions out for the client – in clear language
• Have the client repeat the instructions back to you
Oral Route, con’t

13. Oral Medication Considerations
Tablets and Capsules
• Pouring from multiple dose bottle
– Pour correct amount into bottle cap
– This method prevents contamination if you have to pour some back
• Pour into medicine cup and recap
Note: Always alert the pharmacy when disposing of a
contaminated drug
• Never divide a tablet that isn’t scored,
it will result in incorrect dosage
• Opening a capsule or crushing a tablet when client has trouble
swallowing:
– General rule: crush only uncoated tablets/capsules
– Check “do not crush” list

14. Tablet
Capsule
Scored tablet

15. Liquids
• Obtain a disposable measuring cup with amount markings
• Open medication bottle and place cap on table
top up to avoid contamination
• Place the cup at eye level and pour the medication
• When reading the correct dosage, read at the base
of the meniscus at eye level on a flat surface.
• If you pour too much, pour into the sink - NOT back into bottle
• When administering, place client in a semi-Fowler’s position
• Keep in mind: liquid meds are absorbed more quickly than
solids, such as pills
Oral Medication Considerations

16. Liquids with a syringe
• Used when clients are unable to drink from a cup
• Pour med into cup, then withdraw correct amount, dispose of
excess
• Check dosage at eye level by reading measurement from top
edge of stopper
• To administer:
– Position client in semi-fowler, upright position
– Gently place syringe tip between cheek and 2nd molar
– Instill slowly; ensure medication is being swallowed
Oral Medication Considerations

17. Check dosage at eye level by reading
measurement from top edge of stopper

18. Sublingual
• Medication is placed under the tongue until absorbed
• Drug is mainly absorbed into the blood vessels under tongue
• Caution client not to swallow
Buccal
• Medication is placed between the cheek and the teeth and
held there until absorbed
• Medication is in tablet form
• Caution client not to swallow
Other Oral Medication Considerations

19. Buccal administration
of anti-seizure medication
Sublingual nitroglycerin pills

20. Used when client is:
• Vomiting
• Unconscious
• Unable to swallow
Procedure:
• Lubricate tip with water soluble lubricant after removing foil
• Provide privacy
• Place in side-lying or Sim’s position
• Ask client to take a deep breath and inset the pointed tip past
the internal sphincter (aprox 3 inches)
• Instruct client to attempt to retain suppository at least 20 min
Rectal Medication Considerations

21. Suppository: push through outer and inner sphincters to insert into rectal cavity