when to hold blood pressure meds - page 2
by spicy1 31,619 Views | 12 Comments
At what pressure do you hold your b/p meds? I had originally figured that I didnt feel comfortable giving if there under 110 systolic, but I had other nurses give at 103. Any general rule of thumb if no official doctors order to... Read More
- 0Jul 26, '11 by AeternaQuote from Do-overIn that case, I would give the doctor a call and express my concern about his low BP but high HR. I had a patient a while back who had the same problem (although, low BP was normal for him). The doctor ordered a stat beta-blocker (can't remember which one) and day shift nurse gave it (this was near the end of her shift). When I came on for night shift and reassessed the patient, his BP had dropped further but his heart rate was the same. Called the doctor again, he ordered something else similar to be given stat. I expressed my concern that his BP would tank too far but the doctor said as long as the SBP stays 80 or above, he was willing to go ahead with it.Another thought - picked up a patient awhile back, previous nurse held cardizem d/t low BP (90s I think). However, his heart rate had been consistently in the 140s (a-fib), which is why the cardizem was ordered that day in the first place. The initial dose was held and the doc wasn't notified... I re-checked the BP, had no concern there and gave the med. HR dropped beautifully.
I was nervous but it turned out ok in the end. I just never have qualms over calling a doctor if there's any doubt in giving important medications.
- 0Jul 27, '11 by I<3H2OI totally agree with the PPs. Look at BP trends for this specific patient, ask the pt. themselves if they routinely check their BP at home and how it normally is (I find that most do not), find out the specifics on the drug you are ordered to give, and then once you have all of that information and are still unsure-call the doctor!
I find that some nurses will hold meds (usually BP meds but sometimes it is other stuff) and will not notify the doctor a med is being held. This is a huge issue for some of our docs. ALWAYS call the doc if you are holding a routine med.