Drug study and NCP forms

1. DRUG STUDY
NAME OF PATIENT: ________________________________________________ AGE: __________ CIVIL STATUS:
________________
ADDRESS: ________________________________________________ ATTENDING PHYSICIAN: _______________________
CHIEF COMPLAINT: _____________________________________________________
DATE
ORDERED
(mm/dd/yy)
GENERIC NAME
(BRAND NAME) CLASSIFICATION DOSAGE
MECHANISM OF
ACTION
INDICATIONS CONTRA-
INDICATIONS
SIDE
EFFECTS/
ADVERESE
EFFECTS
NURSING
IMPLICATIONS
RESPONSIBILITIES

2. NURSING CARE PLAN
NAME OF PATIENT: ________________________________________________ AGE: __________ CIVIL STATUS:
________________
ADDRESS: ________________________________________________ ATTENDING PHYSICIAN: _______________________
CHIEF COMPLAINT: _____________________________________________________
CUES NURSING
DIAGNOSIS GOALS/OBJECTIVES
NURSING
INTERVENTION RATIONALE EVALUATIONSUBJECTIVE OBJECTIVE