Can you still give give furosemide if pt bp is 90/60(order is to hold it if for bp <90/60)

Would you still give give furosemide if pt bp is 90/60(order is to hold it if for bp <90/60)

12 Answers

Specializes in teaching, research, and evidence-based practice.

There are multiple factors to consider here, and this is where nursing clinical judgement comes into play. Use your nursing knowledge and assessment to think beyond the written order and the task of giving or not giving the medication. 

  • What is the patient's blood pressure trend? 
  • Are they showing any signs/symptoms of hypotension? 
  • Is the blood pressure reading correct? 
  • How long has the patient been getting furosemide? 
  • What is the usual effect of furosemide on this patient's blood pressure? 
  • Why does the patient have furosemide ordered? 
  • What are the patient's current labs? 

This list could go on, but my point is that there is so much more to consider beyond the actual number in this situation. Just make sure to keep the proper people informed of your decision and rationale, especially the ordering provider and your charge nurse.

I'd look to see how he tolerated the last dose, ie how much it dropped. If there was a significant drop the last time it was given, I would hold it. If his blood pressure normally hangs out that low, no significant drop last dose, and he's tolerating it, I'd likely give it.

Specializes in ICU Registered Nurse.

According to the textbook, it will say yes to furosemide in this scenario, but as for the hospital setting before making any decision the key thing in this matter is to check the blood pressure of that patient 3 times for about 5 minutes apart.

Be sure to keep assessing for change in his/her status. You have to also consider:

  • medicines they have or will receive
  • additional disease processes

Furosemide is the loop-diuretics and the side-effect of this drug is lowered blood pressure. I would consult with the doctor then if still the order is to give his furosemide then I would continue to monitor his blood pressure.

Note: Furosemide is not given too fast due to ototoxicity.

The textbook answer would be give it, since the pressure is not less than 90/60. However from experience I would assess the patient and go from there.

How do the patients's pressures usually run?

If he usually runs say 130s/80s and just dropped to 90/60, I would first recycle a pressure and then consider holding the med after speaking with the physician.

You have to consider the whole pt picture as well like what other meds he has/will receive and other disease processes.

Yes, yes, yes, to the above posters. Any high or low blood pressure re-take the blood pressure at least 3 times about 5 minutes apart before you give or hold a medication and or call the doctor.

Specializes in ICU, LTACH, Internal Medicine.

Access your patient and know his baseline BP, then go from there. And, for God's sake, do not hold it ONLY because BP was 89/60.

I would check a manual pressure three times and average it out, also do an orthostatic BP.This is the time to check with the prescribing physician, before making your decision.

I would still give the drug if, in my nursing judgement, it made sense.

It meets the order parameters.

If, in my judgement, any drug was likely to harm the patient, I would hold it regardless of the parameters.

A couple of points of SBP would vary depending on the cuff, and critical decisions should be based on more than which cuff a nurse chooses.

Specializes in orthopedic/trauma, Informatics, diabetes.

I would hold it and then clarify with physician. I recently had a pt with scheduled Metop. HR runs in the upper 50s. Give the med and we are in the low 40s. Tele calling every 10 minutes. talked with physician and they D/C'd while in the hosp.

Specializes in ICU.

ALWAYS assess your patient~ don't just look at numbers! Does the patient NEED the furosemide because of rales and SOB? Lasix isn't something I like to hold, because they are getting Lasix for a reason. When you hold this patient's Lasix, does he "fill up" and need it? Edema? Weight gain? If the pressure is less than the parameters set forth by the MD, but after assessing the patient, you feel he needs it, then call the doctor.

How much lasix? PO or IV.. Gosh, I have to agree with most of the others here. You have to check a couple of manual bps and the entire patient picture. Technically you are still in range but if you"re still unsure why? This is your patient.. Congrats your critical thinking just kicked in.

Make the call it takes 2 seconds. PO lasix you have time anyway.. SBAR the provider.. It won't hurt.. You'll feel better and YOU CAN move on!

Specializes in Psych ICU, addictions.

Depends on how the patient's BPs trend and whether the patient is currently symptomatic while hypotensive. If it's at or just above 90/60 but he's symptomatic, I'd hold it until I consulted the MD.

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