As a home healthcare nurse, I often administer liquid medications via percutaneous endoscopic gastrostomy (PEG) tube. I was taught to give each drug separately, with a small amount of water in between. A physician I work with says this isn't necessary-the drugs can be mixed together as a cocktail and given at once. He points out that the drugs mix anyway at the other end, so what's the difference?

Am I wasting time by giving the drugs separately?-A.L., MISS.

Not at all. The issue isn't whether the drugs mix when they get to the stomach, it's whether they'll form precipitate in the PEG tube along the way. By separating them and flushing the tube with 30 mL of water before and after giving each drug, you help keep the tube clear. Diluting liquid medications with 30 mL of water is another step you can take to reduce viscosity and prevent occlusion. These simple but important nursing interventions may spare the patient from needing a tube replacement-a particularly burdensome procedure for someone who's already ill and debilitated.

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