A provider prescribes a sublingual medication for a client who has an NG tube in place. Which of the following actions should the nurse take?
A.
Administer the crushed medication through the NG tube.
B.
Dissolve the medication in water and give it through the NG tube.
C.
Administer the medication under the client’s tongue.
D.
Request a prescription for an oral formulation of the medication.
The correct answer and explanation is:
Correct Answer: C. Administer the medication under the client’s tongue.
Explanation:
Sublingual medications are specifically formulated to be absorbed directly into the bloodstream through the tissues under the tongue. This route is chosen for its rapid absorption, bypassing the gastrointestinal (GI) tract and first-pass metabolism in the liver, allowing for quicker therapeutic effects. The presence of an NG (nasogastric) tube, which is often used for feeding or administering medications that require GI absorption, does not interfere with the sublingual route because the NG tube bypasses the mouth entirely, entering through the nose and terminating in the stomach or small intestine.
Option A: Administer the crushed medication through the NG tube.
This option is incorrect because sublingual medications should not be crushed. Crushing could alter the medication’s formulation and effectiveness, and the NG tube delivers the medication directly to the stomach, which is not the intended route for sublingual absorption.
Option B: Dissolve the medication in water and give it through the NG tube.
This option is incorrect for the same reason as Option A. Dissolving and administering sublingual medication through the NG tube would render it ineffective because it would be absorbed through the GI tract, not sublingually. The therapeutic benefit of sublingual medications lies in their direct absorption into the bloodstream via the tissues under the tongue, which is bypassed when administered through the NG tube.
Option D: Request a prescription for an oral formulation of the medication.
While this option might seem reasonable, it is not necessary. The provider has already chosen the sublingual route for a reason, likely due to its quick absorption properties. Switching to an oral formulation could delay the onset of action or change the drug’s effectiveness.
Conclusion:
The correct action is to administer the medication under the client’s tongue as prescribed. The nurse must adhere to the prescribed route to ensure the medication is delivered effectively and safely. Administering the medication via the NG tube or requesting a different formulation would deviate from the intended rapid absorption and could lead to suboptimal treatment outcomes. Therefore, maintaining the sublingual route, even in a client with an NG tube, is essential for therapeutic efficacy.