| Course | NU141CL Pharmacology for Nursing Clinical |
|---|---|
| Unit | Unit 5 |
| Paper type | Case study analysis |
| Length | About 840 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU141CL Unit 5
Six Oral Orders and a New Feeding Tube: A Case Study Analysis of Giving Medications Through a Gastrostomy Tube for a Composite 68-Year-Old Man After Oral Cancer Surgery, Including Three Orders That Must Never Be Crushed
[Student Name]
Purdue University Global
NU141CL: Pharmacology for Nursing Clinical
Unit 5 Case Study Analysis
[Instructor Name]
[Date]
The patient is composite; doses are bracketed where illustrative, and the pharmacist's guidance and facility policy govern tube administration.
The Case
Patient N, a composite 68-year-old retired electrician, had surgery for cancer of the floor of the mouth and cannot swallow safely during healing. A percutaneous gastrostomy tube was placed, and he receives continuous tube feeding at [65] mL per hour. His admission orders, carried over from home, are all by mouth: metoprolol succinate extended-release [50] mg daily, enteric-coated aspirin [81] mg daily, omeprazole delayed-release capsule [20] mg daily, phenytoin [100] mg capsules three times daily, sertraline [50] mg tablet daily and tamsulosin [0.4] mg capsule at bedtime.
Principles for Tube Administration
Medicines given through a tube should be in liquid form when one exists, or crushed to a fine powder and mixed with water if the formulation allows, each given separately with a water flush before, between and after. Some formulations must never be crushed: extended-release products, because crushing releases the whole dose at once; enteric-coated products, which are designed to dissolve beyond the stomach; and some capsules whose beads are designed for delayed release (Williams, 2008). The pharmacist is the key partner in converting orders.
Order by Order
1. Metoprolol succinate extended-release. Must not be crushed; crushing would release a full day's dose at once and could drop his heart rate and blood pressure sharply. Action: ask the prescriber and pharmacist to convert to immediate-release metoprolol tartrate given in divided doses, which can be crushed.
2. Enteric-coated aspirin. Must not be crushed; the coating protects the stomach. Action: request a change to chewable or non-coated aspirin, which can be crushed and given via tube.
3. Omeprazole delayed-release capsule. The granules must not be crushed and can clog tubes. Action: ask about a suspension formulation or an alternative acid suppressant suited to tube use.
Three of the six orders are unsafe to give as written, and none of them would look dangerous on a medication screen.
4. Phenytoin. Available as a suspension, but phenytoin binds to components of tube feeding, and absorption can fall sharply when it is given during continuous feeds. Action: ask the pharmacist about holding the feeding before and after each dose, as many protocols advise, and monitoring the phenytoin level (Williams, 2008).
5. Sertraline tablet. Immediate-release; may be crushed or given as the oral concentrate. Action: crush, mix with water and give separately.
6. Tamsulosin capsule. A modified-release capsule that should not be opened or crushed. Action: ask the prescriber whether to continue it during this admission or switch to an alternative.
Technique
Stop the feeding as directed, check tube placement and residual according to policy and the fundamentals procedure (Potter et al., 2023), flush with [30] mL of water, give each medicine separately followed by [5] to [10] mL of water, and finish with a [30] mL flush. Never mix medicines together or add them to the feeding bag, since mixing can cause clumping and interactions (Burchum & Rosenthal, 2022).
Priorities
The most urgent action is preventing the crushed extended-release metoprolol, which could cause immediate harm. The phenytoin interaction comes next, because loss of seizure control is serious and the effect builds over days. The other conversions are made before their first doses. Sertraline, the one order that is safe as written once crushed, needs no call, but it is still given on its own with flushes, never mixed with the others, so that a clog or reaction can be traced to a single product.
Monitoring After the Changes
Converting forms changes how the drugs behave, so each conversion has its own check. Immediate-release metoprolol given twice daily produces higher peaks than the once-daily tablet, so for the first two days each dose waits on a fresh pulse and pressure reading. Phenytoin levels may fall with feeding interactions, so seizure precautions continue and the level is reviewed. The tube itself is watched for clogging, the commonest practical problem, by noting resistance during flushes.
Teaching for Home
He will go home with the tube for several weeks, and his wife will give his medicines. She is shown how to crush each permitted tablet finely, mix it with water, give medicines one at a time with flushes and never add them to the feeding bag. She receives a written list marking which products are liquids and which may be crushed, and she practices twice with the nurse watching before discharge, so the safety rules come home with them.
Outcome
After a call with the pharmacist and prescriber, five orders were changed to tube-suitable forms and tamsulosin was held. Phenytoin was given with feeds held for [one] hour before and after each dose, and a level was drawn on day four.
References
Burchum, J. R., & Rosenthal, L. D. (2022). Lehne's pharmacology for nursing care (11th ed.). Elsevier.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2023). Fundamentals of nursing (11th ed.). Elsevier.
Williams, N. T. (2008). Medication administration through enteral feeding tubes. American Journal of Health-System Pharmacy, 65(24), 2347-2357. https://doi.org/10.2146/ajhp080155
What the NU141CL Unit 5 assignment asks for
Unit 5 usually presents a patient whose oral medications cannot be given as ordered, most often because of swallowing problems or a feeding tube. Prompts commonly want each order assessed for whether it can be crushed, opened or given as a liquid, the reason when it cannot, interactions with tube feeding, safe technique and the communication needed with the prescriber and pharmacist. Graders expect correct recognition of formulations that must never be crushed, such as extended-release and enteric-coated products, with the danger explained, and for awareness of drug-feeding interactions. Priorities, monitoring after changes and teaching for home show complete thinking beyond the list itself.
How the NU 141CL Unit 5 example is put together
The analysis opens with the patient, his surgery, his continuous feeding and six oral home orders. A principles section explains liquids, crushing, flushing and formulations never to crush, citing a pharmacy review. Six numbered orders follow, each with the reason it can or cannot be given as written and the action taken, with the highlighted line noting that three unsafe orders would not look dangerous on a screen. Phenytoin is flagged for its interaction with the feeding. Technique describes flushes and giving each drug separately. Priorities rank the extended-release crush first. Monitoring after conversion, teaching his wife and the outcome after pharmacist review close it. Each order ends with who was contacted and what changed.
Where the points sit in the NU141CL Unit 5 rubric
Case study analyses in this unit are commonly graded on recognition of formulation hazards, explanation of risks, nursing actions and communication, and completeness. Recognition earns credit for identifying every order that cannot be crushed or opened. Explanation points go to stating why, such as a full day's dose released at once. Nursing action points reward specific steps, including contacting the prescriber and pharmacist, safe tube technique and holding feeds when an interaction requires it. Completeness covers priorities, monitoring after conversions and teaching for home. Sources cited in APA 7 support the formulation rules described throughout. Identifying the feeding interaction, which is not between two drugs, is often what separates the top papers. A clear priority order shows the student can act safely under time pressure.
Common NU141CL Unit 5 mistakes, and how to avoid them
Analyses often treat all tablets as crushable, missing extended-release and enteric-coated products, which is the most dangerous gap. Another frequent oversight is the interaction between phenytoin and tube feeding, since it is not a drug interaction in the usual sense. Some papers recommend mixing medicines together or adding them to the feeding bag. Many forget that a converted drug may behave differently, such as an immediate-release form with higher peaks. Check each product's formulation, explain why any must not be crushed, involve the pharmacist, flush between each drug, consider feeding interactions, monitor after changes and teach whoever will give the medicines at home. When in doubt about any product, ask the pharmacist before the dose.
Get an NU141CL Unit 5 example written to your instructions
Share the Unit 5 scenario exactly as written, with its orders, any diet and liquid instructions, the questions and the rubric. Whatever the patient's problem, the analysis follows each order from the cabinet to the patient with composite values bracketed. No cost for a first custom sample; it typically arrives within 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More NU141CL papers and BSN samples
- NU141CL Unit 1: Discussion Board Post
- NU141CL Unit 2: Medication Worksheet
- NU141CL Unit 3: Administration Note
- NU141CL Unit 4: Route Comparison
- NU141CL Unit 6: Patient Education Handout
- NU141CL Unit 7: Medication Reconciliation
- NU141CL Unit 8: Error Analysis
- NU141CL Unit 9: Post-conference Post
- NU141CL Unit 10: Final Case Presentation
- NU141 Unit 5: Case Study Analysis
- NU140CL Unit 5: Care Plan
- NU140 Unit 5: Case Study Analysis
- NU108 Unit 5: Team Analysis
NU141CL Unit 5 questions, answered
Where can I find a free NU141CL Unit 5 sample paper?
You can read the full NU141CL Unit 5 case study analysis here, covering six orders through a feeding tube, three that must never be crushed, a feeding interaction, technique, monitoring and home teaching, citing three sources. Share your case and we can work through its orders.
Why must extended-release tablets never be crushed?
Crushing destroys the release mechanism, so a dose meant to last all day enters the body at once. With extended-release metoprolol, that could drop heart rate and blood pressure sharply.
How does tube feeding affect phenytoin?
Phenytoin binds to components of the feeding, and absorption can fall when given during continuous feeds. Many protocols hold feeding before and after each dose and monitor the drug level.
How should medicines be given through a feeding tube?
Stop the feeding as directed, check placement, flush with water, give each medicine separately as a liquid or fine powder in water with a flush between, and finish with a final flush.
Can medicines be added to the feeding bag?
No. Mixing medicines with feeds or with each other can cause clumping, tube blockage and interactions. Each medicine is given on its own through the tube.