Documenting oral drug administration

After administering a tablet or capsule, be sure to record:

• drug given
• dose given
• date and time of administration
• signing out of the drug on the patient's medication record patient's ability to swallow the drug you administered (if the patient has had problems swallowing oral drugs)
• patient's vital signs if you give a drug that could affect them
  adverse reactions that arise
• patient's refusal and notification of a health care provider as needed (if a patient refuses a tablet or capsule) omission or withholding of a drug for any reason.

Source: Fundamentals of Nursing made Incredibly Easy!, Lippincott Williams & Wilkins, 2007.