A nurse is preparing to administer enteric-coated aspirin to an older adult client who had a cerebrovascular accident and has difficulty swallowing medications.
The client asks the nurse if she will crush the medication to make it easier to swallow.
Which of the following responses should the nurse make?.
A.
“If I crush it, you might experience a stomach ache or indigestion.”
B.
“I will crush it and mix it in some ice cream for you.”.
C.
“That would release all the medication at once, rather than over time.”.
D.
“Stomach acid will inactivate some of the medication if I crush the medication.”.
The correct answer and Explanation is :
The correct response is:
C. “That would release all the medication at once, rather than over time.”
Explanation:
Enteric-coated medications are specifically designed with a coating that prevents them from dissolving in the stomach and instead allows them to dissolve in the more neutral environment of the small intestine. This design helps to reduce the risk of stomach irritation and allows for controlled, gradual release of the medication.
Crushing an enteric-coated tablet disrupts this special coating. If the medication is crushed, it will be exposed to the stomach’s acidic environment rather than being released slowly in the small intestine. This can result in the entire dose of the medication being released all at once, which might increase the risk of side effects or reduce the medication’s effectiveness.
Here’s why the other options are not appropriate:
A. “If I crush it, you might experience a stomach ache or indigestion.”
While this is partially correct—crushing could indeed lead to stomach discomfort due to the loss of the protective coating—the primary concern is that it disrupts the controlled release of the medication.
B. “I will crush it and mix it in some ice cream for you.”
This is not advisable as it negates the purpose of the enteric coating. Additionally, crushing the medication and mixing it with food could lead to improper dosing and potential adverse effects.
D. “Stomach acid will inactivate some of the medication if I crush the medication.”
While stomach acid can affect some medications, the main issue with crushing enteric-coated tablets is that it prevents the medication from being released in the intended manner (slow release in the small intestine). The enteric coating protects the medication from stomach acid, and crushing it bypasses this protection.
Therefore, the best response is C, which accurately explains the impact of crushing the enteric-coated tablet on the medication’s release and efficacy.