Responsibilities

The nurse should observe the following points when giving an oral drug:
 

• Place the patient in an upright position. It is difficult, as well as dangerous, to swallow a solid or liquid when lying down.
• Make sure that a full glass of water is readily available.
• Assess the patient’s need for assistance in removing the tablet or capsule from the container, holding the container, holding a medicine cup, or holding a glass of water. Some patients with physical disabilities cannot handle or hold these objects and may require assistance.
• Advise the patient to take a few sips of water before placing a tablet or capsule in the mouth.
• Instruct the patient to place the pill or capsule on the back of the tongue and tilt the head back to swallow a tablet or slightly forward to swallow a capsule. Encourage the patient first to take a few sips of water to move the drug down the esophagus and into the stomach, and then to finish the whole glass.
• Give the patient any special instructions, such as drinking extra fluids or remaining in bed, that are pertinent to the drug being administered.
• Never leave a drug at the patient’s bedside to be taken later unless there is a specific order by the primary care provider to do so. A few drugs (eg, antacids and nitroglycerin tablets) may be ordered to be left at the bedside.
• Patients with a nasogastric feeding tube may be given their oral drugs through the tube. Dilute and flush liquid drugs through the tube. However, crush tablets and dissolve them in water before administering them through the tube. Before administration, check the tube for placement. Flush the tube with water after the drugs are placed in the tube to completely clear the tubing.
• Instruct the patient to place buccal drugs against the mucous membranes of the cheek in either the upper or lower jaw. These drugs are given for a local, rather than systemic, effect. They are absorbed slowly from the mucous membranes of the mouth. Examples of drugs given buccally are lozenges and troches.
• Certain drugs are also given by the sublingual (placed under the tongue) route. These drugs must not be swallowed or chewed and must be dissolved completely before the patient eats or drinks. Nitroglycerin is commonly given sublingually.