Editing Nutrition – RN Practice Questions (section)

==Question 9==
A nurse is preparing to administer medications through a client's percutaneous endoscopic gastrostomy (PEG) tube. Which actions are appropriate? '''Select all that apply.'''
# Flush with 30 mL of water before and after the medication administration.
# Crush the extended-release metoprolol succinate tablet and mix it with water.
# Administer each medication separately, flushing between drugs.
# Use liquid formulations when they are available and appropriate.
# Mix all of the client's medications together in the enteral formula.

'''Answer:''' 1, 3, and 4.

''Rationale:'' Flushing with about 30 mL of water before and after administration and between each drug prevents occlusion and drug interaction within the tube lumen, and liquid formulations reduce clogging when they are available and the dosage form is appropriate. Option 2 is unsafe: crushing an extended-release or enteric-coated product destroys the release mechanism and delivers the entire dose at once, risking bradycardia and hypotension with metoprolol succinate. Option 5 is unsafe because mixing medications into the formula causes physical incompatibility, clogging, and unpredictable absorption, and it makes the dose impossible to verify if the feeding is interrupted.