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NCLEX Question of the Day
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A nurse is administering medications through a nasogastric (NG) tube. The client is prescribed a sustained-release tablet. What is the appropriate nursing action?
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Crush the tablet thoroughly and mix it with water before administration.
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Correct answer Hold the medication and contact the prescriber for an alternative formulation.
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Administer the tablet whole through the NG tube with a large flush.
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Dissolve the tablet in warm water before administration.
Rationale
Sustained-release (SR), extended-release (ER, XL), controlled-release (CR), or long-acting (LA) formulations are designed to release medication over a prolonged period. Crushing these medications destroys their time-release mechanism, leading to the potential for excessively rapid absorption of the entire dose at once, which can cause toxicity or adverse effects. Therefore, sustained-release tablets should never be crushed. The nurse must hold the medication and consult the prescriber to obtain an order for an appropriate alternative formulation (e.g., an immediate-release form if suitable, or a liquid preparation).
Dissolving the tablet (if possible) would likely also destroy the release mechanism. Administering a whole tablet through an NG tube is not possible and could obstruct the tube.
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