Hi everyone. I am a recent grad working in long term care. Many of our patients tend to get “sundowners” and will refuse their PM medications. After refused blood pressure medications I see a lot of very high blood pressures for example 178/86, 192/96 etc. Not yet in the defined hypertensive crisis range of >180 systolic “and” >120 diastolic but high enough to make me worry.
Are there any non-pharmacological interventions I can take to help reduce the patients BP? The only things I can think of are having the patient rest, reducing stressors such as reducing noise and dimming lights, but what else is there?
At what point should I call the doctor? I called for the 192/96 (after several high BP readings in 2.5 hours with no symptoms s/a severe headache, I called) and the doctor seemed completely unconcerned, didn’t give parameters for a call back. Am I worrying when I shouldn’t?
Several of the other nurses told me they raise the foot of the bed and lower the HOB but I thought that was only for hypotension. Wouldn’t that intervention increase blood pressure?
Thanks for any help or advice.