RN Nursing · Nasogastric Intubation and Enteral Feedings · Practice question
A patient with a PEG tube is prescribed a crushed medication to be administered via the tube. What is the MOST appropriate nursing action before administering the medication?
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Dissolve the medication in fruit juice to mask the taste.
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Mix the crushed medication with the patient's enteral feeding formula.
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✓
Flush the PEG tube with 30 mL of water before administering the medication.
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Administer the crushed medication directly without any liquid.
Answer & explanation
Correct: Flush the PEG tube with 30 mL of water before administering the medication.
Before administering any medication through a PEG (percutaneous endoscopic gastrostomy) tube, the tube must be flushed with 30 mL of water. This serves multiple purposes: it confirms tube patency, clears any residual feeding formula that could interact with the medication, and helps prevent tube occlusion from medication residue. Flushing before, between, and after each medication is standard practice for enteral tube medication administration. Dissolving the medication in fruit juice is inappropriate because acidic juices can interact chemically with many medications, alter drug absorption, and may cause tube clogging when the mixture reacts with proteins in any residual formula. Mixing the crushed medication directly with enteral feeding formula is also contraindicated because formula can bind to certain medications, altering their bioavailability, and the combination can cause tube occlusion due to physical incompatibility. Administering the crushed medication without any liquid is dangerous as it greatly increases the risk of tube blockage and does not ensure the medication reaches the stomach effectively. The correct procedure is to stop the feeding, flush with 30 mL of water, administer the dissolved or suspended medication, flush again with 30 mL of water, and then resume feeding if appropriate. The pre-administration flush is the priority first action.
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