Document Code No.

CHS/BSN-CURR -RLEFORM-002d
Revision No. Effective Date Page No.
00 02.24.2023 1 of 1

DRUG STUDY

Brand Name: Generic Name: Drug Classification:

Dosage, Route & Frequency Drug-Drug &

Side Effects Adverse Reactions
Drug Action Drug-Food Indications Contraindications
Recommended Prescribed (By System) (By System)
Interactions

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
 EVALUATION TOOL:
UNACCEPTABLE
1-7
Only a few of the drugs were listed down; or some drugs were not
listed down; intended indication and mechanism of action of the
given medication/s as well as the side-effects, contraindications and
nursing responsibilities were incorrect and not relevant to the
assigned patient
SATISFACTORY EXCEPTIONAL REMARKS
8-12 13-20
some drugs were not listed down; intended indication and mechanism Listed down all the drugs; intended indication and
of action of the given medication/s as well as the side-effects, mechanism of action of the given medication/s as well as
contraindications and nursing responsibilities were correct and relevant the side-effects, contraindications and nursing
to the assigned patient responsibilities were correct and relevant to the assigned
patient