NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name
Trade Name
Classification
Dose
Route
Time/frequency
azithromycin
Peak
Onset
Duration
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