Basic Blood Pressure Question

There are numerous reasons why one would have low diastolic pressures. A common reason is being fluid depleted. Often giving volume will increase the diastolic pressure.

sometimes, in the elderly, the DBP seems to drop r/t the rigidity of the blood vessels....do you, perhaps have very good hearing?

Hi there. Sorry to butt in but I'm also curious. What about her pulse pressure?

Hi there. Sorry to butt in but I'm also curious. What about her pulse pressure?

Her pulse pressure was 81 at the first reading (121 systolic - 40 diastolic = 81). This tells you that her left ventricle is doing a very good job. Her MAP was 67 at that reading. Well within limits to provide normal perfusion, although 70-110 is considered a "normal" value.

As one of the other posters stated, she could be a little fluid depleted though.

Evidently, let's start some IV's STAT:cool:

I used to work with a doc who would tell his patients to drink tomato juice to increase diastolic. Seen it help many times.

You said she has ESRD; is she on dialysis? HD can do whonky things to your blood pressure.

Since she's a renal patient and she's asymptomatic, reassure her (over and over again, if necessary) that this reading is fine for her. Blood pressure is a highly personal thing. I have patients on whom, if I were to get a "normal" blood pressure reading, would cause me to be extremely concerned! It all depends on the patient.

Like ghillbert pointed out, the MAP is the most important thing anyway. Giving fluids is definitely NOT recommended for a renal patient, generally. What's important is that her pressure is adequate to keep her perfusing. And if she's awake and able to express her concern about it, she's perfusing.

If this was my patient, I'd address the anxiety issue. So often, patients (and families!) cling to the "numbers" and totally freak out about the numbers. We've all had families who fixate on some number- usually the temperature- and just panic out if it's not 98.6. Some reassurance and honest communication can go a very long way.

Thank you guys for your responses and input. It gave me some more perspective on the situation. Since I have this lady again tonight, I feel more prepared this time! Thanks!