Drug Card Template

NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Peak

Trade Name Onset

Classification

Duration

Dose

Route

Time/frequency

Normal dosage range

Why is your patient getting this medication

For IV meds, compatibility with IV drips and/or solutions

Mechanism of action and indications (Why med ordered)

Nursing Implications (what to focus on) Contraindications/warnings/interactions Common side effects

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)

Lab value alterations caused by medicine Be sure to teach the patient the following about this medication

Nursing Process- Assessment (Pre-administration assessment)

Assessment Why would you hold or not give this med?

Evaluation Check after giving