Pharmacology NUR 1141C Student Name:________________
Generic Name: Drug Classification: Route:
Brand Name: ® Mechanism of Action:
Dose
Drug:
Reason for client:
High Alert Drug: Yes/ No Dose: Focus Assessment:
Focus Assessment: Route:
With or without food:
Vital Signs Assessed: Vital Signs Assessed:
Time (am/pm/bedtime)
3 Contraindications (food/drugs/herbal)
Labs Assessed: Labs Assessed:
3 Side Effects/Adverse Reactions:
Diagnostic Test Assessed:
N/A if not applicable
Generic Name: Drug Classification: Route:
Brand Name: ® Mechanism of Action:
Dose
Drug:
Reason for client:
High Alert Drug: Yes/ No Dose: Focus Assessment:
Focus Assessment: Route:
With or without food:
Vital Signs Assessed: Vital Signs Assessed:
Time (am/pm/bedtime)
3 Contraindications (food/drugs/herbal)
Labs Assessed: Labs Assessed:
3 Side Effects/Adverse Reactions:
Diagnostic Test Assessed:
N/A if not applicable