what are BASELINE vital signs?

  1. 0
    Whenever I give a blood pressure medications such as ACE inhibitors or a lasix, the nurse always would tell me to take my patients' blood pressure before hand. At times, some patients' BP would be 110/90 which is something that I consider as normal. I understand that I still give the medications since these medications are helping the patients to manage their BP. My problem is that the nurse would ask me what is the patients's baseline BP and I have know idea how to find that out. How do I know a pt's baseline? do I look at the pt's BP and calculate the average; it's ridiculous to me that I have to calculate the average since I don't have time to do that during clinical.

    Same goes for the other VS as well. How do I know what is the baseline for the temp, pulse, respiratory rate, and pain.

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  2. 6 Comments...

  3. 0
    My guess is she's asking you for the bp/pulse reads about 15 minutes before you plan to administer a med like dig that has lower hold limits.

    Depending on why the patient came into the hospital, you could look back to their admission vitals for some idea of a baseline, especially if they were coming in pre-op. Otherwise, you could pull up all of the reads over their stay (assuming you have that ability via computerized charting) and take a look for trends up or down. You can't really get a true baseline in this kind of situation.

    You could also look back and see if any data is in the chart from a PCP - that would probably be the closest you'd get to a true baseline.
  4. 1
    A baseline is what a patient's status usually is with regard to any assessment. Baseline orientation, baseline neuro and musculoskeletal status, baseline mobility, etc.

    Baseline VS can usually be figured out by looking at the q shift vital signs over a few days. No calculations are necessary; you can use a round-ish figure. For example, "Systolic usually runs in the high 110s-low 120s," is be an appropriate response. If there is no baseline, as in a newly admitted patient or one whose BP has been all over the place, say so.

    You might you also note VS trends, which may necessitate a conversation with a doc or a med change if the trend is going higher and higher or lower and lower. "The patient came in with a systolic of 110s-low 120s, but I noticed that it has been trending consistently upward and is now in the high 140s-low 150s."
    loriangel14 likes this.
  5. 1
    You don't need to sit down and calculate an average, just look at the trends. Patients may know their own baseline as well. I recently had a doctor take my blood pressure himself (strange, I know) and comment that it was low... it was around 105/65 which is perfectly normal for me. I told him as much and we moved on.

    It's important to know a patient's baseline so you know how to react to VS outside the "normal" range. When I worked inpatient, if we knew a patient had a baseline HR in the 50s, it was nothing to get excited about. If a patient's baseline was clearly in the 70s-80s and it was a patient with hydrocephalus, once they dipped below 60 all hell broke loose.
    loriangel14 likes this.
  6. 1
    Quote from konp
    Whenever I give a blood pressure medications such as ACE inhibitors or a lasix, the nurse always would tell me to take my patients' blood pressure before hand. At times, some patients' BP would be 110/90 which is something that I consider as normal. I understand that I still give the medications since these medications are helping the patients to manage their BP. My problem is that the nurse would ask me what is the patient's baseline BP and I have know idea how to find that out. How do I know a pt's baseline? do I look at the pt's BP and calculate the average; it's ridiculous to me that I have to calculate the average since I don't have time to do that during clinical.

    Same goes for the other VS as well. How do I know what is the baseline for the temp, pulse, respiratory rate, and pain.
    I am confused.....you are passing meds and say you are in nursing school (ADN) in some posts then ask for lists of nursing schools (ADN,BSN) after you have posted that you are in school.

    What position do you have that you are passing meds? Knowing a patients baseline vital signs can be very important as some meds, even though they are for B/P, are being given to ease the hearts workload even in the presence of a "low" B/P. Baseline vital can be found in the patients records from previous vitals taken or previous hospital visits.

    Look at the chart, past and present, to see where the patient lives.
    sandanrnstudent likes this.
  7. 0
    Baseline is the patient's "normal", without any influence of new meds. So, let's say my blood sugar normally is 110-140. I start steroids and it jumps to 200-300. The MD orders insulin and today my BS is 150. I am now close to baseline.
  8. 0
    A baseline is not always the patient's normal. Usually, a baseline reading is just a reference point. If you're gathering baseline information before administering a medication it is generally used to evaluate the effectiveness of the drug although sometimes it is used to determine dosing. Sliding scale insulin administration, for example, requires that you obtain a blood glucose reading (baseline) to determine how many units to administer based on the reading you obtain. You might give a system altering medication to a patient in a highly acute state (as in mannitol to a patient with trauma induced increased intracranial pressure) - that highly acute state is not their "normal", but it gives you a starting point for evaluating the effectiveness of the medication. If your patient's "baseline" ICP is 20 mmHg and it drops to 15 after administration, then you know the drug and dosing are achieving the desired effect. Often times the reason for administering medications is to GET TO the patient's normal.

    In your example, taking a baseline blood pressure before administering a medication that lowers blood pressure tells you how effective the drug is in lowering blood pressure. It can also tell you if a drug is too effective. Think of blood pressure as a continuum instead of a static state - it fluctuates with certain circumstances. If your patient has a blood pressure of 110/90 prior to administering an anti-hypertensive, you have to take into consideration that giving them one will lower their blood pressure even further since that is what the drug is designed to do. Unless you have specific orders, you should use your nursing judgement to decide whether or not that's a good idea.


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