BULACAN STATE

UNIVERSITY
COLLEGE OF NURSING
City of Malolos, Bulacan

DRUG STUDY
Patient’s Initial: _______________________ Age: ________ Gender: _____ Date Handled: _________________ Medical Diagnosis: ______________
Chief Complaint: _________________________ Hospital: ________________________________________________ Ward/Clinical Area:
__________________

Medications Date Route of Mechanism Indication Contraindication Client’s Response Nursing

Ordered/ Administration/ of Action Responsibilities
Given/ Dosage
Taken Frequency
Generic: Date Ordered: Dosage: N/A Potentiates Indicated in ➢ Contraindicated Therapeutic Effect: Prior:
Lorazepam N/A the effect of patients with in patients with ➢ Verify
Lorazepam is used
GABA, patients physician’s
Brand: Ativan ➢ Anxiety to relieve anxiety
Route: N/A depress the hypersensitive to order regarding
➢ Insomnia
Date Given: CNS, ands drug, other Side Effect: drug
Classification: from anxiety
N/A suppresses benzodiazepines, ➢ Assess patient
benzodiazepines the spread
or transient
or the vehicle ➢ Drowsiness hypersensitivity
Frequency:
(Antihistamine of seizure
situational
used in parental ➢ Dizziness to drug.
N/A
drug) activity.
stress
dosage form, and ➢ Loss of ➢ Review the
Date ➢ Preoperative
patients with coordination patient’s chart
Discontinued: sedation
acute-closure ➢ Headache for allergies.
N/A
➢ Nausea ➢ Enumerate
glaucoma.
➢ blurred vision medication not
should be
➢ Contraindicate ➢ change in taken with
for intra-arterial sexual Thioridazine.
administration. interest/ability ➢ Assess patient
➢ Constipation medical history
➢ Heartburn ➢ Warn the client
➢ Change in to avoid
appetite smoking and
alcohol during
treatment.
➢ Discuss
therapeutic
effect of the
drug
➢ Provide
appropriate
health teaching
regarding the
drug
➢ Monitor vital
signs.
➢ Prepare
medication
according to
the order of the
physician.

During:
➢ Administer
drug in right
route, right
 dosage, right
time.
➢ Offer glass of
water upon
administering
the drug.
➢ Administer
drug with or
without food.
After:
➢ Reassess vital
signs
➢ Monitor the
patient
response to
the administer
drug.
➢ Note for the
client’s
response to
the drug
therapy include
the therapeutic
effect.
➢ For any
serious
adverse or side
effect report to
the physician.
Student’s Name: Prieto, Stiffany T. Yr&Sec/Group No. 3B/G4 Clinical Instructor: Mrs. Jessica Villano RN, MAN

BulSU-OP-CON-23F1
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