What should the nurse clarify with the provider before administering medications to a client who is NPO and receiving enteral feedings?

When considering medication administration for a client who is NPO (nil per os, or nothing by mouth) and receiving enteral feedings, it is critical to understand the compatibility and form of medication to ensure patient safety and effectiveness of treatment. In this context, the correct choice to clarify is the administration of metoprolol extended-release (ER) via an NG tube.

Extended-release formulations, like metoprolol ER, are designed to dissolve slowly and release medication over a longer period. If such a formulation is crushed or altered for enteral administration, it can lead to a rapid release of the drug, potentially causing adverse effects or toxicity. Additionally, crushing an extended-release tablet negates its intended pharmacokinetic profile, therefore risking both the efficacy of the medication and the safety of the patient.

The other medications mentioned—levothyroxine, acetaminophen, and amoxicillin—can generally be administered through an NG tube, provided they are soluble in the appropriate medium or in liquid form. Levothyroxine, specifically, is usually recommended to be taken on an empty stomach but may be given enterally if needed, and many formulations of acetaminophen and amoxicillin are available that are appropriate for NG tube administration.

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