what will be change of blood preesure?

Fiona59 · Sep 15, 2009

These are homework questions, right?

Research Demerol for the answers.

geekgolightly, BSN, RN · Sep 15, 2009

These are homework questions, right?
Research Demerol for the answers.

Here here.

If you like, post what you think the answers are with your rationale and then I bet people will be willing to help you think it all through.

hnwxmo · Sep 15, 2009

there are real clinic happenings of out patient surgery, not home work questions. patients are transfer to recovery room right after surgery within 1minute, patient's BP change obviously. That's what i would like to discuss about. Thanks a lot.

nyteshade, BSN · Sep 15, 2009

Critically think...what class is demerol? Obvious position changes...things like that.

EDRN-2010 · Sep 15, 2009

Not related to the demerol but I know that using the wrong sized cuff is sometimes the culprit. I recently had surgery and right before shift change the PACU nurse took my BP with an adult size XL cuff...it took up my entire arm so obviously when it was taken 5 minutes later with the right size cuff the reading was higher.

A person who is overweight can have their BP taken same as everyone else provided you use the right size (width/length cuff...we have have different width cuffs, an adult thigh cuff thats 16 x 42 is our largest. Where were you thinking that you woud want to take it?

If you cross your legs your pressure would be higher. Lots of things affect the blood pressure readings...laying down versus sitting up, sitting on an exam table versus sitting in a chair with a back, having the arm raied above the heart versus below it versus at the level of the atrium, not having the cuff properly lined up with the brachial artery, inflating the bladder then deflating it, then starting over again, etc.

If a person is in pain their BP will go up, when the pain goes away, their pressure will go down. As far as your question about demerol specifically, I am kind of at a loss for words. The patient receives IV demerol after surgery and their pressure changes....well they just got demerol, maybe had anesthesia and just had surgery...all these things affect vitals

I am really trying to figure this out, are you saying that you are confused/surprised that IV demerol and position changes would affect vital signs? I could be way off but I think you aren't getting many replies because this seems like pretty obvious stuff and maybe you just aren't wording your question right???

Fiona59 · Sep 16, 2009

Here's a couple of questions for the OP:

1. Where did you gain your nursing education?

2. I've had a quick look at your posting history, you've worked in Home Health, a Dr. Office, etc. Are you working in a hospital, or surgical/recovery room in a private clinic?

3. Is English your second language?

RedCell · Sep 16, 2009

Can very body here discuss what will be change of blood pressure after patient had Demerol by IV within 30 minutes? If patients cross their legs, their blood pressure will be elevate or lower? If patient overweight, where will be the best location to take blood pressure? Thanks for you discussion.

While meperidine is a substandard shoddy drug that should only be used for postoperative rigors, it certainly does have an interesting history. It was discovered by a pharmaceutical company that was looking for a structural analogue to atropine. It actually resembles atropine at the molecular level and it is also the only opioid that can (usually does) elevate heart rate.

Anways, meperidine acts as a negative inotrope that decreases myocardial contractility and lowers SVR due to histamine release. Basically, while it might increase cardiac output, you will still see hypotension 30 minutes after IV administration because the half life is around 3 hours and it has an active metabolite.

On the flip side however, you can also unintentionally make a patient hypertensive if you administer meperidine to a dude already on MAOIs or SSRIs by inducing serotonin syndrome.

I don't know the answer to the crossing the legs question, I guess it would depend on the individual patient as well as their comorbidities.

On fat people I have found that the best place for an accurate blood pressure is either accomplished by placing an arterial line or by utilizing a thigh cuff that I wrap around their neck. As an added note, I have also been known to use the thigh cuff as a modified SCD to prevent DVTs in the EJ and IJ.