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Name: __________________

ADMINISTRATION OF ORAL MEDICATIONS

LAB STUDY GUIDE

(Winter, 2025)

University of New Brunswick

Faculty of Nursing

INTRODUCTION
During this clinical term, you should have the opportunity to administer medications by selected
routes (i.e. oral, topical, and rectal) to your assigned clients in the hospital. It is very important
that you understand the basic principles of pharmacology and the legal implications of drug
administration. This lab will focus on oral medications, yet many of the principles will apply to
medications administered by all routes. The lab provides only the basics and you will build on
this over the course of your education in clinical experiences and coursework. In the course
N2132 Pharmacotherapeutics you will further explore these concepts.

We expect that you will be able to:

• Be able to describe some of the key medication terminology
• Be able to seek out the physiological mechanism of action of medications
• Give consideration to the legal implications of drug administration
• Be able to apply the 6 main “Rights” of medication administration
• Calculate a prescribed medication dosage
• Administer medications to your clients safely and responsibly

Required Readings:
Astle, B. J. & Duggleby, W. (2024) Potter & Perry’s Canadian Fundamentals of Nursing (7th ed.)
Toronto, ON: Elsevier.

Chapter 35 of your Fundamentals of Nursing text is about medication administration.

Complete the study guide in preparation for the Oral Medication Lab and
bring it with you.
1. Outline the difference between trade and generic drug names.

Trade:

Generic:

2. Familiarize yourself with Canadian drug legislation.

a. Who do you think enforces the Controlled Drugs and Substances Act?

b. What are some potential consequences of violating this act?

3. Explain why nurses must consider OTC, legal, and illicit drugs that clients might take in
addition to prescribed drugs.

4. The therapeutic effect of a drug is also called the desired effect. It is the reason the drug
was prescribed. What is a medication side effect and how are side effects different from
adverse effects?

5. Differentiate between a drug allergy and a side effect of a drug.

6. What is an anaphylactic reaction and why is it relevant when administering a drug?

7. Briefly explain the following terms:

 • Trade Name: Also known as the brand name, it is the name given to a drug by the
manufacturer. It is typically capitalized and more recognizable (e.g., Tylenol).

• Generic Name: The drug’s official, standardized name, as listed in pharmacological

references. It is typically not capitalized and is used universally regardless of brand (e.g.,
acetaminophen).

a. Who enforces the Controlled Drugs and Substances Act (CDSA)?

• The Royal Canadian Mounted Police (RCMP) and Canada Border Services Agency (CBSA) are
primary enforcers of the CDSA.
• The Health Products and Food Branch Inspectorate of Health Canada also plays a role in compliance
and oversight.

b. Potential consequences of violating this act:

• Criminal charges: Depending on the severity, penalties can range from fines to
imprisonment.
• Loss of professional licensure: Health professionals may lose the right to practice.
• Financial penalties: Heavy fines for individuals or corporations.
• Damage to reputation: A criminal record can lead to long-term social and professional
consequences.
• Restriction of travel: Convictions can affect international travel, especially to countries like
the United States.

Why must nurses consider OTC, legal, and illicit drugs clients might take in addition to prescribed drugs?
• Drug interactions: OTC, legal, or illicit drugs can interact with prescribed medications, altering their
effectiveness or causing harmful side effects.
• Masking symptoms: OTC medications may mask symptoms of underlying conditions.
• Complications with treatment: Illicit drugs or alcohol can interfere with drug metabolism, potentially causing
toxicity or reducing therapeutic effects.
• Client safety: A comprehensive understanding of all substances a client uses ensures safe and effective care.

Differentiate between side effects and adverse effects:

• Side Effect: A predictable, often mild, secondary effect of a medication (e.g., drowsiness from antihistamines).
They are usually not harmful but may be bothersome.
• Adverse Effect: An unintended, harmful, and severe reaction to a medication (e.g., liver damage from
acetaminophen overdose). These require immediate attention and may necessitate stopping the medication.

Differentiate between a drug allergy and a side effect:

• Drug Allergy: An immune system response to a medication, often involving symptoms like rash,
hives, or more severe reactions like anaphylaxis.
• Side Effect: A non-immune, predictable, secondary response to a drug that is typically less severe
and unrelated to an immune reaction.

What is an anaphylactic reaction and why is it relevant when administering a drug?

• Anaphylactic Reaction: A severe, life-threatening allergic reaction characterized by difficulty
breathing, swelling, hives, and a drop in blood pressure.
• Relevance: Nurses must recognize and act quickly (e.g., administering epinephrine) to manage
this emergency. Proper patient history and observation after drug administration can prevent or mitigate
such reactions.
 a. Onset of action

b. Peak concentration

c. Serum half-life

d. Therapeutic concentration

8. What do you think a nurse should do if a patient refuses a medication? (offer your opinion)

9. Safe practices in giving medications are essential to avoid a drug error. You will read about
the ten rights of medication. The first six ‘rights’ are perhaps the most important ones to
commit to memory. For each of these, list the ‘right’ and beside it write a key point to
safely address the idea or a question you can ask of yourself?
Preparing to give medications to a patient in hospital
There are three (3) conditions that must be met before a nurse may legally administer
medications:
• The medication order must be valid
• The prescriber (physician/nurse practitioner) and nurse must be licensed or be a student
• The nurse (or student) must be knowledgeable regarding the medication to be given

In order to have the required knowledge, many students find it helpful to begin to learn about
their client’s medications by making drug cards or some record, saving them, and using these as
an ongoing reference. You will find that clinical instructors differ in their expectations for how
students prepare to demonstrate their medication knowledge. Over time, you may find an
approach that works best for you in order to demonstrate knowledge about the medication you
are giving.

Purchasing pre-printed drug cards or accessing the information electronically may be effective
for some people. The process of recording key information may promote better learning and
retention of information. In N2132 (Pharmacotherapeutics) in the winter term, students have
used Medication Regime Sheets and it may be helpful to use this format in the fall as well.

1. Complete a Medication Regime Sheet or make a drug card (index card or using and
online template) for the medications listed below (use the Davis or other nursing drug
guide or other trustworthy resources)

2. Bring the sheet/cards to the Oral Medication Lab.

Medication 1: Digoxin
Medication 2: Oxazepam

If you choose to make a drug card, the following headings and information should be included:

-classification -possible side effects

Brief explanations of terms:
• Onset of Action: The time it takes for a drug to start producing its intended effect.
• Peak Concentration: The point when a drug reaches its highest concentration in the
bloodstream, resulting in maximum therapeutic effect.
• Serum Half-Life: The time it takes for the concentration of a drug in the bloodstream to
decrease by half, influencing dosing frequency.
• Therapeutic Concentration: The drug concentration range in the bloodstream that
achieves the desired effect without causing toxicity.

What should a nurse do if a patient refuses a medication?

• Respect autonomy: Patients have the right to refuse. Understand their reasoning without judgment.
• Educate the patient: Explain the purpose, benefits, and risks of the medication to address concerns.
• Document: Record the refusal in the patient’s chart, noting the reason and any actions taken.
• Notify the provider: Inform the prescribing physician or healthcare team for further evaluation or alternative interventions.

9. The (focused on) Six Rights of medication administration and key points:
1. Right Patient: Verify the patient’s identity using two identifiers (e.g., name and date of birth).
2. Right Medication: Double-check the medication name and ensure it matches the order.
3. Right Dose: Calculate and verify the prescribed dose to avoid under- or overdosing.
4. Right Time: Administer the medication at the correct time to maintain therapeutic levels.
5. Right Route: Ensure the medication is delivered by the appropriate route (e.g., oral, IV).
6. Right Documentation: Record administration accurately, including the time and any patient responses.

Rule 1-Right Patient:

Rule 6-Right Documentation:
•Verification of patient’s identity
•Collecting personal information •Maintaining necessary records as a legal requirement
•Utilizing advanced technology and patient identifiers •Recording name of medicine, dose intake timings,
patient’s reaction to the medicine intake etc.
Rule 2- Right Medication:
Rule 7- Right to Refuse:
•Double-check protocols
•Highlighting errors in medication prescriptions •Accepting patient’s refusal to medication
•Medication Reconciliation •Foster open communication
•Using barcode scanning system •Providing alternative medicines
•Giving the right medication to patient Rule 8-Right Assessment:
Rule 3- Right Dose:
•Thoroughly assess patient’s condition
•Administrating the right dosage for patient safety •Check if medication accurately aligns with the
•Accurate measurements of prescriptions assessed condition
•Precise Dosing Rule 9- Right Education:
•Dosing protocols
Rule 4- Right Route: •Providing patient with all the information regarding the
prescribed medications
•Exploring administration routes such as oral, •Communicating the purpose and possible side effects
intramuscular etc. of the medicine administered.
•Identifying patient’s condition and then choosing the Rule 10-Right Evaluation:
right route
Rule 5- Right Time: •Monitor patient’s response towards the medicine
•Carefully evaluating whether there are any adverse
•Administrating medications at the right time effects on patient’s health from medicine prescribed
•Emphasizing the drawbacks of missed dosage
-physiological action(s) -adverse reactions
-use(s) -contraindications
-normal dosage range -nursing implications