Multiple BP meds & dialysis- to give or not to give.......

what is your rationale for NOT giving them?.....what is the peak and 1/2 life of ea.? has the patient had problems in the past with this being done?

ooo i stepped in this one, no icu nurse here! lol .....however, you need to know the things i mentioned and, which if any of her meds she had had earlier in the day (they should have only given those that will not dial. out.)
remember, a HTN person's BP is good BECAUSE of the meds, and ordinarily they wouldnt be held for this BP....now, that said, were these meds routinely , ie every day, given together? or only on dialysis days? if the latter, the drop, if it were to happen, may not be apparent for a while (again depending on peak of ea) perhaps the next shift. If you get a chance, check her trend of BPs.......it is better to be cautious.....good luck

If they had different mechanisms of action, I would have looked to see how the previous nurse handled it, and if they were given together, I would have done it again. If there was no previous record, I might have spread them out a bit.

I'm not an ICU nurse, but I'm not sure you need an ICU nurse for this question - lots of patients are on dialysis and blood pressure meds.

I would have given them unless there was an order to hold them. morte is absolutely correct...the patient's BP was wnl *because* the meds were effective. Besides, they have different actions: lisinopril is an ACE inhibitor that relaxes blood vessels --> easier blood flow --> the heart pumps more effectively; metoprolol is a beta blocker and has a SHORT half-life so is usually given BID. It reduces the HR, heart muscle contractility and cardiac output --> reduced BP.

When in doubt about what meds to hold or give to dialysis patients I've always found the dialysis nurses to be great resources

i work for davita dialysis and they always tell the pt's never to take bp meds on dialysis days becuz the pts always come in with low bps. but i guess you have to do what you are instructed to do by your instructor

This patient had already been dialysised and had a bp wnl. I would also be willing to bet that those meds were home meds.

i'm not a dialysis expert by any means, but i'm assuming they tell the patients not to take their BP meds right before dialysis.... and to monitor the BP afterwards.

if my pts are going to 1st shift dialysis in the AM, i don't give the BP meds, and then i check the BP when they come back and make my decision from there.

if they are going to 2nd shift dialysis in the PM, i will give the BP meds, as they have time to peak and do their job, pt has a stable BP, and let dialysis do it's thing at night.

you are right but our 2nd shifts starts between 10am and 12 noon so the same thing applies to them to, no pm shift