Blood pressure

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Question, does anyone have protocols for what is considered high/low BP in the elementary and middle school child? I recently have had numerous students taken off ADHD meds by PCP due to elevated BP, but when parents tell me the BP reading, it surprises me. Example, middle school boy with BP of 122/78.

Just looking for guidelines for better understanding.

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Specializes in Pediatrics Retired.

Tenex has been used for decades to treat ADD/ADHD and I've never seen elevated BP on the elementary level but I have heard of it having an effect on BP as the kids start maturing into adult sized people. Otherwise I'm haven't heard of it with any of the stimulants.

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Specializes in ICU/community health/school nursing.

I found an undated NIH publication for you, but it doesn't answer your question about protocol, or what one would do with a high reading in a school setting. I've only had to monitor BP in a teen once, and that was when they were trying to decide if there was something wrong with the kidneys. I would suggest getting a doctor's orders if a parent is asking you to monitor BP (that can be done at home).....

https://www.nhlbi.nih.gov/files/docs/guidelines/child_tbl.pdf

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I have not been asked to monitor these BPs, these kids are daily meds at school, which have been placed on hold by the MD due to BP. It is one particular PCP that is doing this, but it's concerning to me as many of my students go there. With state testing approaching, it concerns me that these kids are not medicated. I am always trying to understand and learn new things. As a nurse with a cardiac background, some the BPs did not seem high to me, but I am not a doctor....

Thanks everyone!

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Thank you!!!

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The students are all on Ritalin, Adderall or Vyvanse that are having meds held for high BP.

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Specializes in Pediatrics Retired.

Some middle school boys - and girls - are already adult size, along with hormones and fitness level, and fat composition, and on and on to consider, so no it's not high. Is this MD fresh out of residency?

I'm skeptical...again!

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Some middle school boys - and girls - are already adult size, along with hormones and fitness level, and fat composition, and on and on to consider, so no it's not high. Is this MD fresh out of residency?

I'm skeptical...again!

I too am skeptical!

It's a NP that is doing this, but this NP does not manage the ADHD medications.

My middle school student is adult size! He's bigger than me!

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Specializes in Pediatrics Retired.
I too am skeptical!

It's a NP that is doing this, but this NP does not manage the ADHD medications.

My middle school student is adult size! He's bigger than me!

TH NP is trying to inflate their own ego. I think it would be worth your while to attempt to communicate your concern with the prescribing physician.

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Specializes in School nursing.
TH NP is trying to inflate their own ego. I think it would be worth your while to attempt to communicate your concern with the prescribing physician.

This. And then ask for guidelines as to what is high BP that med should be held for.

And ditto on some middle school students that are adult sized. I have a few 7th grade boys and girls that are taller and weigh more than me and trust me, I'm not a small lady by any means at all.

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TH NP is trying to inflate their own ego. I think it would be worth your while to attempt to communicate your concern with the prescribing physician.

I questioned this NP in the past and it did not turn out well. I think I will attempt to speak with the psychiatrist! Thanks! I too believe there is ego involved. There have been multiple instances that her patients needed the care of a specialist and she wouldn't refer them.

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Thanks everyone for your input!

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