[mrsluckyaz]

I need to know the normal guidelines to use for BP when giving antihypertensive medications if the physician does not leave specific orders - I was taught to hold if sbp <120 and call the doctor for his order. I have had several different rules stated by different RNs. Can anyone give me some uptodate guidelines? Thanks

[earle58]

i've typically seen, hold for sbp < 90-100: hr < 55-60


leslie

[PsychNurseWannaBe]

I normally see the parameters < 90 systolic, < 50 diastolic and pulse < 60. I do have one person where the pulse is < 65.

[meandragonbrett]

It greatly depends on A) Other meds your patient is taking B)What is wrong with them C) What medication is it? (beta blocker, CCB, ARIIB, ACEI) D)Is this a PRN or scheduled?

I don't hold BP for SBP <120.

[NursingNurse]

I usually see for SBP < 100 or HR<60 to hold the medication.

Alot depends on the person, and what else is going on in the clinical picture. If there are no parameters set by the MD, and I take the BP befoe giving and it's borderline, I'll call and ask for parameters, that way it's clear what the MD wants.

[Angie O'Plasty, RN]

Also, it really depends on the dosage. If I'm giving a beta blocker to a CHF'er, I really want to give that med to help the heart function, so I might give it if the patient's SBP is only 100, if the med is Coreg and the dose is low, like 3.125 mg.

We can go lower because our patients are monitored and vitals are taken pretty frequently on our unit. I'd be more conservative in a LTC setting because you don't have the resources there to adjust like the hospital does.

Best to call the doc for parameters with cardiac meds, IMO, if you ever have a question.

[NursingNurse]

Also, it really depends on the dosage. If I'm giving a beta blocker to a CHF'er, I really want to give that med to help the heart function, so I might give it if the patient's SBP is only 100, if the med is Coreg and the dose is low, like 3.125 mg.

We can go lower because our patients are monitored and vitals are taken pretty frequently on our unit. I'd be more conservative in a LTC setting because you don't have the resources there to adjust like the hospital does

See, that's what I've been saying on my unit since I got there!!!

When I'm working on the adult pulmonary unit, people are wickedly paranoid about giving anti-hypertensives when the BP is borderline (like
SBP 95-99 and asymptomatic!). It's just frustrating, and I wonder if everyone is understanding the pharmacology behind a medication like lopressor or coreg, esp in a post MI patient.

[peridotgirl]

can metoprolol be used also as an anti-anxiety agent? I read that beta-adrengeric agents are sometimes used to treat symptoms of anxiety pts. That is what my med-surg books says... I just wanna clarify. thank you.