Don't understand this weird-a%&! parameter

[GLORIAmunchkin72]

Can someone please explain this bp med parameter:

"Don't give if sbp is less than 70". It's not a mistake.

[ZippyGBR, BSN, RN]

Can someone please explain this bp med parameter:

"Don't give if sbp is less than 70". It's not a mistake.

Systolic Blood Pressure

[Esme12, ASN, BSN, RN]

Can someone please explain this bp med parameter:

"Don't give if sbp is less than 70". It's not a mistake.

Sometimes severe cardiac patients with very poor ejection fractions need certain pre-load (the force/amount of blood returning to the heart)and after load ( the force against which the heart pumps) reductions to circulate blood and can tolerate a lower systolic B/P. The med, which may usually be held for systolic B/P less than 100 or a mean of 60 must be given to this patient or the go into heart failure/pulmonary edema. the meds can be given with lower B/P's but not too low. When all else fails CALL THE MD AND CLAIRIFY RIGHT NOW! We don't know the patient nor the MD. BUt I have seen this type of order a thousand times

It is "Do not give if SBP (systolis B/P) less than 70"

http://wichita.kumc.edu/hastings/chf.pdf

http://tinyurl.com/6ly7fbj

[Christen, ANP]

It's pretty specific - I'd clarify it with the MD, then make sure I passed on in report "it's not a mistake." what med was this for?

[TiffyRN, BSN, PhD]

I think some of the previous posters may be right about the med being more for heart failure, but should be clarified.

I did work with an MD that was notorious for writing out orders that were just common sense hospital procedures. One time I checked off admission orders on a patient, uncomplicated TIA r/o CVA. He was resuming many home meds including the patient's regular dose phenobarbital, hold for RR

I'm sorry, but if my patient's RR is less than 8, you can be assured I will not be giving phenobarbital and I will be notifying you immediately!

[enigmaticorange]

if the issue was tachycardia and the patient was able to tolerate a systolic in the 80's (and many are) then I would not see the problem with this. The opposite is true as well- Ive notified docs about BP's that are 180/100 and in a CVA, this is OK.

[cherrybreeze, ADN, RN]

I don't think it was the "sbp" that the patient was questioning (as several have explained that it is systolic BP....). I think they were just using the abbreviation. I think it's the 70 that is being asked about.

[GLORIAmunchkin72]

Thanks everyone. The order was clarified (and reclarified) and it's not a mistake. As a few of you have mentioned it's probably patient specific. I guess the doctor knows best!:)

[Horseshoe, BSN, RN]

thanks everyone. the order was clarified (and reclarified) and it's not a mistake. as a few of you have mentioned it's probably patient specific. i guess the doctor knows best!:)

maybe so, but i would definitely want to know and understand his rationalization. if called into question later on in a lawsuit, we cannot say "i figured the doctor knew best." if we understand the rationale, then we can follow the order with confidence and know that we have standards of practice to back us up.