Checking Vital Signs in LTC

[oliverandmollycat]

Hi,

I'm a new grad (psychiatric nurse) starting in long term care tomorrow. I've worked in long term care as an aide before, and I noticed that the nurses rarely checked vital signs before giving meds. My question is, in LTC do nurses still check BP before giving a BP med for example? Or before giving a diuretic? I realize policies vary between facilities but I just want to know what some experienced nurses do? I think I would be checking vitals before administering meds that can alter them, but will I have time with a 30 patient caseload? I know that regular vitals are usually once a month in LTC. Just wanting some opinions from more experienced nurses please!

Thanks!

[psu_213, BSN, RN]

Obviously the policy is going to vary from facility to facility and it will depend on the doctors order.

In general, however, I would look at it like this: if someone is taking a BP med at home are they going to check their BP every time before they take the med? In the vast majority of the cases, no.

Obviously, I would be checking it with some regularity after starting a new med, but I do not see the practicality of checking the BP every time before administration of every BP med--particularly if they have been taking the med for some time, routine VS checks show a normal BP, and they have no s/s of hypotension.

[loriangel14, RN]

When doing a med pass for a large number of patients doing VS for every one would be impossible.In LTC they are usually done monthly unless there is reason to be concerned.psu is right, people at home will not be checking their BP daily.

[Daisy_08, BSN, RN]

It would be impossible!! At home they would not be checking BPs more then once every month. If the doc feels the need for OT to be done more often then they'll order it.

In ltc you need to become aware of changes and any "off" things in your rt's. For example a rt who is getting dizzy when standing. You should still be doing HR when giving dig due to its potency.

Good luck in your new job

[Lpn1226]

Our facility depends on the dr. Sometimes we check bp especially if they run low or just starting out. Other residents who are stable with the meds we check 2x per week for Bp meds and diuretics.

[JiNgEr187]

In my facility we have to have a blood pressure noted when we give the bp meds. I think it more depends on the dr and the pt as to whether you have to get the bp everytime. I have seen patients whose bp is usually normal and when I check it its too low for the med. So I hold the med then go back and check the bp again n itll be fine. It just varies on the patients and the dr orders I think.

[eatmysoxRN, ASN, RN]

I work acute care cardiac, but in that setting I'd be sure to recognize s/sx of hypotension and check it if they displayed any signs. I'd always check a hr before giving a bb since it's only a few seconds to be sure it's okay.

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