Special Situations

Flush the tube with water before and after medications and give each drug separately to prevent clogging.

Use liquid forms when available and do not crush extended-release or enteric-coated drugs without checking.

Coordinate with the nurse to hold tube feedings when a drug must be given on an empty stomach.

Check blood glucose before sliding-scale insulin and give the dose matched to the ordered scale.

Treat hypoglycemia (low glucose with shakiness/sweating) with a fast-acting carbohydrate per protocol and notify the nurse.

For hyperglycemia (high glucose), follow the ordered protocol and report the reading rather than giving carbohydrates.

Give PRN medications only when the resident meets the ordered indication and within the allowed interval.

Document the reason, time, and the resident's response after a PRN dose.

Do not give PRN drugs on a fixed schedule or withhold them when the criteria are met.

Recognize severe allergic reactions (hives, lip swelling, breathing difficulty) as emergencies requiring immediate help.

Notify the nurse for adverse reactions, lack of expected effect, refusals, or values outside a hold parameter.

Stop administration if a resident coughs or chokes and address airway safety before continuing.

Aging can slow drug metabolism and increase sensitivity, raising the risk of side effects and falls.

Monitor older adults closely and report changes such as dizziness or confusion.

Expect that lower doses and slower adjustments ('start low, go slow') often apply to older residents.