guidelines for BP

Last post was moved to Best Response section and would very much like to read it, I cannot find it, can anyone help?

OP, Esme moved your post to see if you can get the best response...

What type of BP med is it???? ACE, Beta-Blocker????

Last post was moved to Best Response section and would very much like to read it I cannot find it, can anyone help?[/quote']

No, this means the thread was moved from the original forum you posted in to the more appropriate nursing & patient medications forum in the hopes of eliciting a better response

To answer your query, Often this is not a straight guideline but patient specific and/or facility protocol. BLS protocol might be min systolic of 120mm/Hg since BLS cannot initiate or provide IV fluid support. In a hospital setting the number may be patient specific (higher or lower) depending on baseline, comirbid conditions, etc.

I meant what does the BP have to be before I can give NTG and Morphine? In other words, if BP is above....I ca give it and below it I can't

You should follow company policy and their recommended drug reference.

What are the guidelines & parameters for BP before NTG & Morphine administration so as to prevent BP bottoming out?

What are the guidelines & parameters for BP before NTG & Morphine administration so as to prevent BP bottoming out?

The parameters should be written into the med orders, and if not, you should call and get them added. It can be different for each pt.

Generally, we don't hold meds until the SBP

You should follow company policy and their recommended drug reference.

^I agree...This...

OP, I thought you meant BP meds...that's what I get for reading 1/2 sleep!

And if it is for emergent chest pain,we hook them up to a bedside and give it...get another nurse in the room to grab a bolus, call the cardiologist and get their opinion....

I didn't read carefully before answering before- I was thinking BP meds. You don't have time to mess around getting parameter orders so you need to use nursing judgement. I give the first SLN if they are above 100 and then get on the phone while waiting 5 min between doses. Get the md to the floor and let them make the decision for the next one if the SBP is dropping.

Pt's BP was about 110/78 but she bottomed out after 1 SLN. Trendelenburg and NS bolus got her BP back up, but afterwards I questioned my judgement for giving it to her at all and wanted to learn from it and prevent this in the future

Pt's BP was about 110/78 but she bottomed out after 1 SLN. Trendelenburg and NS bolus got her BP back up, but afterwards I questioned my judgement for giving it to her at all and wanted to learn from it and prevent this in the future

I wouldn't hesitate to give SLN at 110. (We don't have a written policy with parameters for SLN- just nursing judgement and "if the BP tolerates it.") I would probably not do Trendelenburg, though. I don't believe it is considered best practice anymore. Was the pt symptomatic?

In any case, you can't always prevent the BP dropping- you never know how a pt is going to respond to meds they haven't gotten before. Some people drop like a rock after 1 SLN, some only a little. I stay in close contact with the doc if I have doubts. Get the O2 going, get the EKG done, get meds and a bolus ready, and get the backup you need if things start going wrong. If the pt is having new CP, a doc should be examining them anyway.

I've only been a cardiac nurse for a year, so I'd like to hear what more experienced nurses have to say.