have you ever noticed

[nursepenny]

I am an experienced LPN, who works at a 75 bed acute care hospital. I work in ICU/SDU here. For the past 2 nights, I have taken care of an 84 y/o female CVA victim. Apparently, it was from hypertension, as the CT showed no bleed. My question (or statement) is this: does positioning of a patient affect blood pressure? I noticed when my patient was placed on her right side, her blood pressure would sky-rocket. Example, while lying on left side BP was 117/64. Shortly after repositioning patient to right side, BP was 211/127. She was given 10 mg Labetalol slow IV push. Bp then went to 179/122. Finally topped out 197/133. The doctor on call was notified and no new orders given. I then repositioned patient to left side and her BP almost bottomed out at 103/64. I thought this was a drastic drop. Patient is totally unresponsive, since CVA, save minimal movement to painful stimuli. I would like some input from other nurses who have had this experience or who have any suggestion as to why this happened. This is my first post and I hope I have given enough history without being to "wordy". LOL. Am looking forward to hearing from anyone.

[ResearchRN]

Positioning definitely effects blood pressure. If in bed a patient should not be lying on either the right or left side, but should be lying on their back when taking a BP

[nursedawn67, LPN]

yes positioning does definately affect BP. When I was pregnant I had very high BP and had doctors orders to lay around especially on my left side, to help keep the BP down. Always take BP while lying on the back, not the sides.

Good topic!:)

[coffeejavule]

*gets pen and paper out and takes notes for future heads-up*

[caroladybelle, BSN, RN]

Patients lying on their left side generally have lower bps than when lying on right side. As such, patients with preeclampsia are generally put on their left side.

It has to do with cardiac function.

[nursepenny]

Hi all!

Thanks for the response I got about positioning patients. I just re-read my thread and realized I did not state the highest BP 197/133 was while patient was on back. And I also forgot to say patient was lying on pillows under right or left side (whichever the case may be). So actually she was not lying directly on either side. I do appreciate your input and look forward to further discussion like this. It always help when you have other opinions and experience. We all learn from each other........:roll :roll