Nurse of 2 weeks experience on telemetry floor. Pt. transferred from smaller hospital with decompensated hf, scant information provided. Upon admission orders written for nitro drip and lasix drip. Stable bp's/hr's ( slightly over 100 sbp/hr 60-70) on nitro drip while titrating up for two hours, then no change for two hours as desired sbp achieved. Lasix drip without titration. Output not increased. Four hours in, pressure suddenly 70's systolic, hr 50's. Drop happens as titrating off nitro gtt as provider now thinks pt. septic and wants it d/c'd.
No other cardiac meds (beta/ace/arb/etc.) on board due to nonadminister prior to transfer, pharmacy issues, and now blood pressure issues.
Why would heart rate go down as blood pressure does? Without a whole host of additional information I understand that no conclusions can be drawn, but my undeveloped gut would say hr should attempt to compensate.
Thanks for any input as I learn all day at work and when my head clears at home come up with more questions.