Thanks for the input on pulse pressure, I had noticed it but had not put as much emphasis on it as the extremes she was having. She was my pt for this week, and the primary had not had time to get a good look at her MAR before handing it to me and FREAKED when I asked why a pt with HTN was getting no BP meds. (I thought there was a reason). She called MD, apparently they took here off due to hypotension. She had been given a one time dose of clonidine twice (two days apart). When her BP stayed down, the MD gave a PRN order for clonidine 0.1 mg if her SBP is low. She had been taking Hyzaar 100/25mg daily, Hydrazaline 50mg q6h, and Toprol XL 100mg daily. Hx:HTN, rt carotid endarterectomy (had lt carotid done last week also), CVA, TIA. She was in because she had several "black-out" spells where she did not lose consciousness. In one spell she lost vision in one eye and started to fall to one side. Cardiac markers negative for TIA, abnormal labs: sed rate 34, BUN 45, Creat. 2.2, B/C ratio 20.5, PTT 0.9, Ca 8.2, protein 6, albumin 2.7. She stated 258#, used to be 5'8, now probably 5'3 (she was not weighed in hosp.) She does not want to eat but is not dehydrated-good turgor, mucus membranes ok, taking fluids well. Don't know if I left something out or if this is too much info, but I am really confused here. She states that her doctors don't know why she fluctuates this much, has been doing this for years, just not this bad. My instructor doesn't know why her diastolic was fluctuating either. Guessing reaction to going off her meds, but why the extremes and diastolic changes?
Thanks for the input!