Bulacan State University

COLLEGE OF NURSING
City of Malolos, Bulacan

DRUG STUDY

Patient’s Initial: __________________ Age: ______ _ Gender: ____________ Date Handled: _____________________________
Medical Diagnosis: ______ ____________________________ Clinical Area: _____________________ ___________
Chief Complaint: ________ ____________________________

Medications Date Ordered/ Route of Mechanism of Indication Contraindication Client’s Response Nursing Responsibilities
Given/ Administration/ Action
Taken Dosage/
Frequency

Generic: Date Ordered: Dosage:

Brand: Date Given: Frequency:

Classification: Date Route of

Discontinued: Administration:
Student’s Name: __________________________________ Yr&Sec/Group No. ____________________