Medication Administration and Nursing Documentation Template

Name____________________________________

Nursing Interventions

Client Education

Medication Administration (Dose and Route)

Medication Name and Type

 

 

Drug Class

 

Therapeutic Uses (Indications)

Complications

Interactions

Contraindications

 

Expected Pharmacological Mechanism of Action (How it Works)

 

____________________________________________

 

Evaluation of Medication Effectiveness

 

 

 

 

© 2021 Chamberlain University. All Rights Reserved

 

It appears that you’re looking for a template to document the administration of medications, including details on nursing interventions, client education, and other relevant pharmacological information. Here’s a structured template that you can use:

**Name**: ____________________________________

### **Medication Details**

– **Medication Name and Type**:
___________________________________________

– **Drug Class**:
___________________________________________

– **Therapeutic Uses (Indications)**:
___________________________________________

### **Medication Administration**

– **Dose**:
___________________________________________

– **Route**:
___________________________________________

### **Nursing Interventions**

– **Intervention 1**:
___________________________________________

– **Intervention 2**:
___________________________________________

– **Intervention 3**:
___________________________________________

### **Client Education**

– **Key Points to Educate the Client On**:
___________________________________________

– **Potential Side Effects**:
___________________________________________

– **When to Seek Medical Attention**:
___________________________________________

### **Pharmacological Information**

– **Expected Pharmacological Mechanism of Action (How it Works)**:
___________________________________________

– **Complications**:
___________________________________________

– **Interactions**:
___________________________________________

– **Contraindications**:
___________________________________________

### **Evaluation of Medication Effectiveness**

– **Criteria for Evaluating Effectiveness**:
___________________________________________

– **Outcome After Administration**:
___________________________________________

**© 2021 Chamberlain University. All Rights Reserved**

This template should help structure the information necessary for documenting medication administration and related nursing responsibilities. You can fill in the appropriate sections based on the specific medication being administered and the individual client’s needs.

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