[spottybug]

I work in a peds hem/onc/bmt transplant unit and we take bp's on all kids, all ages Q4 hours.

[MeghanRN]

I'm with spotty.

Its BP's q4hours regardless of how old your are. (I also work at a childrens hospital)

I would think that especially after surgery, or in the emergency dept that you need to assess and complete a full set of vitals q4hours.

How do you know the parent didnt just bring you a septic child? Pedi pts can look good on the outside, but have the worst vital signs ever...

Kids go bad QUICK. Its best to try and stay ahead of the game and get those vitals.

I find it really interesting that preceptors are saying they dont take them... odd..just...odd..

[a4n6nurse]

While BP changes in children are latent signs of decompensation they still need to be trended. Remember for pediatric pt's they hold their BP until they loose it. While it is most important to check additional signs/symptoms in concert BP is still always measured. Along with the recorded BP assess mental status/irritability, cap refill- central VS peripheral, skin temp-turgor-and color. And as was previously mentioned we are seeing more cases of pediatric hypertension. If you don't check you will never know. BP is a part of complete vital sign, and it is not age dependent.

[JustaPatient]

I am a patient at a peds hospital, they have ALWAYS done routine bp's on me. Not sure if this helps I am not a nurse, this is just what I have noticed.

[Myscrubs]

I totally agree with a4n6nurse. Children can effectively compensate for circulatory dysfunction (primarily by increasing heart rate, systemic vascular resistance, and venous tone), maintaining normal blood pressures despite significantly compromised tissue perfusion. Consequently, hypotension is a very late and ominous finding . The challenge for the clinician is to recognize children in shock early (before they develop hypotension), when they are more likely to respond favorably to treatment. This is true when a infant/child is critically ill. But in the Peds ER (where I work) and outpatient clinics, we take the BP in all children 3 yrs old and up (unless it's a very sick infant/child).
However, children, even very young babies, can have high blood pressure. The American Heart Association (AHA) recommends that all children age 3 and older have yearly blood pressure measurements, this is also supported by the American Academy of Pediatrics (AAP). Early detection of high blood pressure will improve health care of children.

[HRM672]

I agree with the all kids, q4 or with other vitals.

I work on a cardiac floor in a children's hospital, so it's crucial on our floor. But I have seen many, many kids who could have been diagnosed way earlier than they were, and BP can be one part of the clue for some defects. So, I think a complete and thorough assessment will always include a BP.

[chubbsrn]

depends in my hospital NICU if there 3:3 than we do one q12hrs unless otherwise indicated and of course if the bp is out of norm those who are 1:1 we take the quite frequently due to the fact that they are on a thousand meds. In our peds unit we take 1 blood pressure upon admit and really thats it. unless, of course we deem it necessary. good rule of them. I was taught that for any child ages 1-7 you can average their systolic bp as followed (age in yrs + 90) don't know if that is still the case since prehypertension came into play

[nocangel2]

Our protocol is infants-2y: admit then QD
2y-8y-Q8hr
8y and on-with scheduled VS unless otherwise ordered.
This of course changes if they are post-op then it is the same protcol as adults. Or if they have a condition that indicates more freq monitoring. i.e. VP shunt placement, cardiac issue etc. You use your clinical judgement.

[jeepgirl]

yes, you do monitor blood pressure. while a dropping BP is a late sign of decompensation (the kids tend to use other mechanisms to keep it up until the last possible minute) it is recommended that all ages get BP's while hospitalized and then routine screening at age 3 for outpatient. how often to get the bps? (on admit, q4, q12, etc and at what ages) would be on your hospital policy and your nursing judgement.

[JessPedsRN]

I work on a surgical peds floor that also gets medical overflow. Our hospital standard for vital signs in general is q4h along with our q4h assessments, unless stated otherwise, and this includes a BP. Now realistically, getting a good BP on a infant/toddler isn't going to happen. Also, in non-critical peds settings, BP is generally the last vital sign to go downhill when something bad is going on.