UNIVERSITY OF PERPETUAL HELP SYSTEM DALTA LAS PINAS

COLLEGE OF NURSING

DRUG STUDYPatients Name: _________________________________

Room & Bed No.: ________________

Diagnosis: ________________________________DRUG NAMEACTIONINDICATIONCONTRAINDICATIONADVERSE REACTIONNURSING RESPONSIBILITIES

Generic Name:

Brand Name:

Dosage:

Route:

Frequency:

CLASSIFICATION:

Students Name: _________________________________

Level/ Section: ____________

Area: ________________

Clinical Instructor: ________________________________

Date: _____________

Shift: _________________

gudecena/file