BP high or low -when to call the Dr. ?

KelRN215, BSN, RN · Sep 2, 2016

Why would you call the MD for a BP of 110/69? That's a normal healthy BP...

What was the other information in the question?

EDRN1 · Sep 2, 2016

Call the Dr or do intervention when pt is symptomatic. Think weakness, dizziness, pale, diaphoretic, etc.

vanilla bean · Sep 2, 2016

What is the normal range for systolic pressures? What is the normal range for diastolic pressures? Now that you've broken that down, is the blood pressure given within normal limits?

blondy2061h, MSN, RN · Sep 2, 2016

On NCLEX style questions "call the doctor" is rarely going to be the correct answer. NCLEX is interested in NURSING interventions, not passing the buck.

akulahawkRN, ADN, RN, EMT-P · Sep 2, 2016

This is nursing, not medicine. Calling the physician usually isn't going to be an answer you are going to choose. OP, look up "normal range" for both systolic and diastolic blood pressure values. You should find something about the BP you provided and that will likely be that the BP is well within a normal range.

The next step is a bit higher level of thinking/consideration. What is my patient's normal range (everyone will be different) and how does this fit relative to that? Is my patient symptomatic?

Here's a quick case to illustrate this point, from back when I was a paramedic: I had an altered mental status patient who had symptoms of frequent nausea/vomiting/diarrhea for 3 days with poor to no effective oral intake. She was a GCS 5 (E1, V1, M3) and she normally is fully alert/oriented. Her normal BP is approximately 180/100. Her BP was 124/72 when I took it on scene. So, I had a symptomatic patient whose blood pressure was well below her normal level (even though it's textbook normal). What's the problem and what do we as nurses do about it? You're at the beginning of the process of learning this stuff. That was a very real patient by the way, and she had a good outcome. I'm not going to outline what I did with that patient because I was functioning as a paramedic and my interventions were primarily based in medicine, not nursing, though experienced nurses can take a reasonable guess as to what I did.

cmkayne · Sep 3, 2016

I thank each one of you for your responses. This was a select all that apply question. The scenario was a patient post op in the PACU...the question, "What assessments findings warrant a call to the docotor?," He had stridor, Resp rate 10, restless & shouting, disoriented & oliguria, temp 94.8. I selected each of these (which were correct) PLUS the BP of 110/90, which was wrong. Again I ask why and what BP would I call for?

NICUismylife, ADN, BSN, RN · Sep 4, 2016

Everyone is trying to pull this answer out of you. You should be able to answer this question on your own. Would you call the dr if the patient had a body temp of 98.4? Why not? Because it's WNL.

What is a normal BP range? There is your answer. 110/69 is a normal healthy BP.

As far as when you call the dr, there is generally a PRN order for antihypertensives or a pressor (whichever the case may be) for over or under a certain BP that the dr. states. So, it's pretty uncommon to have to call the dr. for BP at all unless the PRN med isn't cutting it. The docs I work with normally want the SBP between 90-160, then you give the med, and IF the meds aren't enough, then-and-only-then, do you call them.

But I'm guessing you're first semester, and not so much dealing with "the real world" yet, so it sounds like your instructor was simply trying to get you to identify abnormal findings rather than do any real critical thinking.

If you are still confused as to why you got it wrong, you may need to speak with your instructor one-on-one.