BP Med/Transfusion Question

[FloatFNP-C, BSN, MSN, NP]

Hi!

Quick question-

Patient had a low H/H of 8/25 and BP 95/38, HR 120s. Per MD orders, I infused 1 unit PRBCs and took vitals like q2h. BP came up nicely 140s/80s- 150s/85and HR 90s. She may or may not have had to go back to the OR to find out why the H/H dropped (I work nights so MD would assess in the morning). Anyway, I gave 80 mg Micardis which she takes normally at home before I left that morning.

My question is, what this the right thing to do or should I have held it, thinking her BP would come back down if she was indeed having a bleed? I don't know, I am just having some anxiety over hoping I did the right thing. My charge nurse said it was fine, but I'm having new grad jitters :)

Thanks for listening!

[FloatFNP-C, BSN, MSN, NP]

That low BP was about 8 hours before the BP meds.... And stabilized almost immediately. Just to clarify!

[icuRNmaggie, BSN, RN]

It was safe to give the Micardis to the pt with a BP 150/80 and not actively bleeding.

In the future, if you are second guessing yourself, just give the doctor a call.

[icuRNmaggie, BSN, RN]

Also, you probably should have checked the am H&H result first just to be certain that the bleeding had stopped .

It was a good question.

[MunoRN, RN]

In a patient who might be continuing to bleed I'd be more worried about the 150/85 than the 95/38. It varies depending on the type and source of the bleed, but typically you want the BP normal to low normal rather than high.

[FloatFNP-C, BSN, MSN, NP]

Yes, absolutely, I rechecked the h/h and it was maybe 8.1/28 ish so, stable, after the 1 unit of blood.