Tarrant County College
Associate Degree Nursing Program
Student Medication Administration Record
Student Name ______________________________________ Semester _______________
Medication (M) / Classification (C) / Mechanism of Action (A)
Route (R) / Dosage (D) / Frequency (F)
(g) generic / (T) Trade
M (g)
C
A
General
Client Teaching
(T)
Key Nursing Assessments
(VS, Labs, Output, etc)
Specific to Individual Clients
Date
Init
Date
Init
Date
Init
Date
Init
Date
Init
Date
Init
Date
Init
R
D
F
R
D
F
R
D
F
R
D
F
R
D
F
R
D
F
R
D
F
Intended
Therapeutic Effect
Common Side Effects
Possible SEVERE Adverse Effects