Quick question from a new grad on a tele floor.

Specialties Cardiac

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I am a new grade just off of orientation on a telemetry floor. I had a patient come in with a SBP in the 190's with a HR in the mid 40's. What's the intervention?

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Specializes in Med-Surg/ Critical Care.
I am a new grade just off of orientation on a telemetry floor. I had a patient come in with a SBP in the 190's with a HR in the mid 40's. What's the intervention?

The patient needs something to lower their BP without affecting their heart rate. I find when they first come to the floor from the ED they usually haven't taken any of their daily medications so I would give this patient all of their meds but you definitely want to check with the LIP before giving any Beta Blockers or Digoxin.

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Specializes in ER, progressive care.

Did you take care of this patient? I'm curious to know what YOU think or what you did. What about your preceptor?

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Specializes in Cardiology.

Hydralazine IV. will increase HR and C/O while vasodilating & decreasing BP

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I honestly didn't know what to do. Other than a high BP and a low HR the patient wasn't showing any other symptoms. So I called my charge nurse. We waited five minutes then retook the VS. the BP dropped after the patient was settled into bed for the night. But thank you medic0681. I won't forget that in the future.

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Specializes in Pediatric/Adolescent, Med-Surg.
Hydralazine IV. will increase HR and C/O while vasodilating & decreasing BP

Agree with this. Hydralazine is always the IV BP med of choice if you only want to lower BP and not affect HR. I would also look at the bigger picture and try to figure out WHY the pt is hypertensive and yet brady. Is the pt just in a sinus brady or are they experiencing some other arrhythmia

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