Questionable parameters?

[GLORIAmunchkin72]

Would you give a patient a blood pressure medicine if his or her systolic pressure were 85?

[untamable07]

I am a student, graduating May 2009, but no I wouldn't. We are taught it has to be over 90. 85 is close but not close enough to medicate. Hope this helps.

[untamable07]

Sorry I thought you meant diastolic.

[morte, LPN, LVN]

there may be good reason for this, ie very diseased heart...

[UM Review RN, ASN, RN]

No, I wouldn't.

[morte, LPN, LVN]

what is the background on this patient?

[GLORIAmunchkin72]

I don't understand why the doctor would not change the parameter to a higher systolic number. He has been questioned about it twice.

[UM Review RN, ASN, RN]

Some docs want the patient to have a beta blocker to help the heart function and will give Coreg 3.125 with parameters to give with a BP of over or equal to 85.

However, I would expect that the patient would be in the Unit where someone could immediately reverse a systolic that was going too low. Floor nurses generally have too much to do and cannot continuously monitor a pt's BP as well as the CCU can.

[morte, LPN, LVN]

Some docs want the patient to have a beta blocker to help the heart function and will give Coreg 3.125 with parameters to give with a BP of over or equal to 85.

However, I would expect that the patient would be in the Unit where someone could immediately reverse a systolic that was going too low. Floor nurses generally have too much to do and cannot continuously monitor a pt's BP as well as the CCU can.

perhaps the patient is DNR....and the OP, why not ask why instead of for a change, after all it is the doc practicing medicine not ye

[Altra, BSN, RN]

Is this a renal patient? If so, it may be appropriate to give it.

[GLORIAmunchkin72]

I'm beginning to feel a little better about this order after reading your answers. Some doctors don't like to be second-guessed and some don't like to explain. I would still have a hard time giving the med if the actual systolic number is 85 because it could very well drop to 80 or 75, barely enough to sustain life.

[Kymmi]

Most doctors dont like to be second guessed or have to explain however that is their problem and not mine. If they are asking me to do something and I do not understand their rationale they are going to have to explain and convince me why it should be done...if they can't do that they can find another nurse to do what they can't explain or they can do it themselves.