Increased blood pressure. What to do?

[wonderwoman92]

Hi,

Im having a difficult time with this - if a patient has a increase in blood pressure and pulse, especially the same day after surgery i.e. peg insertion, and denies pain or discomfort. Temp is fine, o2 is fine on oxygen..what to do? Notify the doc of the change? Say the BP was 160/90 and pulsw 103

What could be going on? What about without surgery and bp and pulse elevated? No signs of infection either.

I guess im having a hard time figuring out when it's appropriate to call the doc or if its raapid worthy, or something that will settle on its own..sorry novice nurse.

Thanks.

[NewMurse1014]

It depends on a lot of factors: 1) Is the pt exhibiting signs of observable distress? 2) What's the trend of BP/HR in the past 24 hrs? 3) Did the pt skip BP meds because of the surgery?

Usually if I have a pt with abnormal vitals, I would check the trend first, making sure it's within the pt's baseline. If it's out of the baseline, I would recheck the BP in both arms again. If it's still abnormal, I would check if there's any PRN meds that I can give (meaning that MD is aware and we can give those meds when the criteria are met). Finally if there's no PRN meds or if they don't work then I would notify the MD.

Never be afraid to ask questions/discuss with your colleagues or call for help if your gut feeling is telling you something is wrong with the pt. Better to be safe than sorry.

[wonderwoman92]

There were no observable signs of distress, no BP meds missed and the trend was BP and pulse only elevated within the last few hours.

Just not understanding what could be going on at this point.

[RNNPICU, BSN, RN]

What was the patient's pain assessment? Patient was post op, what was the pain medication schedule?

[grizun]

Had the patient been working with PT just before having vitals checked?