General Nursing (RGN)
ADMINISTRATION OF ORAL MEDICATIONS (MIXTURES)
This procedure covers administration of a prescribed liquid oral medication or mixture. Accurate identification, shaking when required, eye-level measurement, swallowing assessment, observation and documentation are essential because liquid strengths and volumes vary.
Purpose
- Deliver a prescribed therapeutic or prophylactic dose
- Provide an oral formulation for a patient who needs or prefers liquid medication
- Support safe, accurate medication administration and evaluation of response
Indications
- A valid prescription for a liquid oral medication
- Patient can safely swallow the prescribed preparation
- A liquid formulation is prescribed or clinically appropriate
Equipment
- Medication treatment chart or authorised electronic medication record
- Original labelled bottle of the prescribed oral mixture
- Calibrated oral syringe, medicine cup or measuring spoon as appropriate
- Clean tray, water and disposable tissue
- Pill or bottle opener only if required
- Hand hygiene supplies and waste receptacle
Preparation
- Check the medication, concentration, dose, patient identifiers, allergies, expiry and prescription.
- Read the label and product instructions for shaking, dilution, storage and measuring requirements.
- Assess swallowing ability, level of consciousness, nausea and any reason the oral route may be unsafe.
Procedure steps
- Perform hand hygiene and identify the patient using approved identifiers.
- Explain the medication, purpose, dose and route; obtain cooperation and respect the patient's right to refuse.
- Check the bottle label against the medication record before opening and gently shake the bottle when instructed.
- Place the cap with its inside protected, hold the bottle with the label uppermost and pour at eye level.
- Measure the prescribed dose using a calibrated device; do not use an unmarked household spoon.
- Recheck the measured volume against the prescription, close the bottle and clean any residue from the outside.
- Position the patient upright or as upright as possible, give the mixture and offer water if appropriate.
- Observe that the dose is swallowed and monitor for coughing, vomiting, allergy or other adverse response.
- Dispose of used materials, clean reusable equipment and perform hand hygiene.
- Document administration or refusal and evaluate the patient's response at the appropriate time.
Precautions
- Do not estimate a dose or use a different concentration without clarification.
- Do not give a suspension without redistributing it when the label requires shaking.
- Do not force medication or conceal it in food without an authorised plan and patient-centred discussion.
- Report damaged, expired, contaminated or incorrectly labelled preparations before administration.
Aftercare
- Leave the patient comfortable with water and the call bell within reach.
- Store the preparation according to its label and facility policy.
Nursing considerations
- Use an oral syringe for small or critical volumes when indicated.
- Follow the manufacturer's instructions and local medication policy for storage and beyond-use dates.
Possible complications
- Incorrect dose from inaccurate measurement or inadequate shaking
- Aspiration, choking or vomiting
- Allergic or adverse medication reaction
- Contamination or deterioration of the preparation
Patient education
- Explain why the mixture is prescribed and how to report side effects or difficulty swallowing.
- Advise the patient not to alter the dose or share the medication.
Documentation
- Record the medication, concentration, dose, route, time and authentication in the medication record.
- Document refusal, vomiting, difficulty swallowing, adverse response or any clarification obtained.
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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