Did I Do Something Wrong? - page 2
I came home and cried feeling like a truly incompetent nurse. I work on a very busy SDU/Tele unit taking overflow from med surg. I had a patient who was being diuresed r/t chronic bladder retention... Read More
Jul 10, '11Check the BP when giving push/IV lasix; just something they taught me in school. I have run into other nurses who do not and it makes me nervous. If I say something it's not acknowledged as serious in this matter.
Experience is the best teacher. I also check the BP for myself just to be sure. It's not a diss on anyone, ultimately you're going to get the charge or doc who will ask if it was double checked.
Jul 10, '11I think you did great. Prior to admin, you looked at the BPs, noticed the trend was low, you thought it would be ok. The BP was rechecked when you learned it was low, you made sure the patient was asymptomatic and you called the doctor. I'm a new nurse, but that all sounds pretty reasonable to me. And now you'll do even better next time, because if you're giving IV lasix, you'll check the BP just prior to admin and you'll watch the patient even more carefully. I don't see any reason for you to beat yourself up here. Good work!
Jul 10, '11I always check before giving diuretics. We administered IV lasix at 0800 and 1600 here, I do routine vitals at those times anyways, but even before a one time order, I always check. Just to make sure!
Jul 11, '11You gave the lasix based on a BP taken within 2 hours. Acceptable, especially on that kind of a unit.
He had a borderline pressure to begin with. The drop in pressure was a RESPONSE to the med.
If he was asymptomatic, I would notify the doctor, watch closely and have just given the situation a little more time. I think the fluid bolus was the error here.
Let the body do what it can to adjust, we can't fix everything in a few minutes.
Jul 11, '11I would not have checked before administration under those circumstances, either. If the patient had a SBP less than 90 (two hours prior) or a massive bleeding wound (oh no!), then I might have checked.
Jul 11, '11The problem is that at 0400 his SBP was already below 100. This becomes imperative to re-check his BP prior to giving Lasix 40 IV.