Nursing Related Learning Experience Manual

Name of Student Yr & Sec

Clinical Instructor Area
Date of Exposure Hospital

DRUG STUDY
Name of Patient Rm/Bed No. Age
Address Date of Sex
Admission
Chief Complaints
Diagnosis

Brand Name
Generic Name

Date Ordered

Rationale for the

Drug Order

Classification
Actual Dose/
Frequency/ Route

Indication

Mechanism of
Action

Contraindication

Side Effects

Adverse Reactions

Nursing
Considerations/
Responsibilities

College of Health Sciences Department of Nursing NOTRE DAME OF DADIANGAS UNIVERSITY