Not working on a medical floor, I have very few resources when a patient spikes a high BP. We don't even have a large or small BP cuff in our unit!! one size for all.. yeah.. I have to be choosy about when I call the on-call psych doc (i work nights) because they get very ****** at calls about blood pressures. and I certainly didnt learn in nursing school
to give ativan for high blood pressures, but i do everyday. Ativan seems to be the cure for everything on our unit. If we are lucky, we can get a clonidine PRN.
being a new grad, I get very unsure when to panic about BP.
150/95....unless this is a sudden spike...ativan cures all
160/100??? ativan and call the doc for clonidine?? wait for day shift to sort out? the doc is usually ****** if i call for this.
180/105.. im calling doc =P.. the doc said to give ativan.. hmmmm will this person have a stroke on me??
226/126.. this one was impervious to clonidine and ativan and I eventually sent her to the ED =P
our detoxers tend to run very high.. I was piling this detoxing guy with ativan for BPs 156/102 ish and HR 112..he was barely shaking and denying detoxing. He denied a history of HTN and tachycardia. Perhaps he just was an extremely anxious guy with a HTN? He still didnt sleep =P He was D/Ced today and joked about the lectures he got from 4 nurses to follow up with his PCP about the BP.
I had a patient have a DT a few weeks ago who did not manifest the common CIWA Signs and symptoms. and now i find myself thinking sleepy patients > sick patients.
Ive been researching clonidine and reading about rebound BP. As clonidine can cause drowsiness and depression, it isnt a great everyday BP med and i worry about sending our HTN pts home with it and having them not take it.
basically, this was an extremely long-winded way of saying that I'm sick of high blood pressures and they scare me.. any wisdom?