Hold Diltiazem if SBP <105 or HR <60. So should we hold if BP 91/60 and HR 105

LindseyRN86 · Jul 5, 2013

One or both parameters met= hold the med

nurseprnRN, BSN, RN · Jul 5, 2013

You are not wrong. "Or" means, well, "or."

S.G. · Jul 5, 2013

I would hold the med. If I saw his HR trending up, I'd call the physician. Sometimes the MD will want you to give the med but you cannot do so without a new order. With those parameters, the medication should not be given.

loriangel14, RN · Jul 5, 2013

The SBP was

Esme12, ASN, BSN, RN · Jul 5, 2013

Diltiazem for anxiety??

He is on Diltiazem 30 mg for night time med. In MAR this med is used for Anxiety and it said "Hold if SBP

martymoose, BSN, RN · Jul 5, 2013

hmm, never heard of that med for anxiety. beta blockers, yes, i have heard of them for anxiety, but not that.

Since parameters were given, thats what the order was. I would have held it.

But i'd also wonder- is the person dehydrated? is this where they run b/p wise? is this their normal heart rate?Did they just get up?. Sometimes I will wait a bit, and recheck a manual b/p. If thats not their norm, maybe something else is going on?

Mully · Jul 5, 2013

I've heard of doctors prescribing calcium channel blockers for anxiety, but I don't think it's done very much or is widely accepted.

Hold the drug. I don't understand why you wouldn't. Did this trifecta of degree varying nurses give explanation as to why you should've gave it?

Camille L. · Jul 6, 2013

You followed the parameters the doctor gave for administering the medication. I would have held it. I don't understand why 3 nurses told you to give it. I would ask them what their reasoning was. Either way you did the right thing.

TheCommuter, BSN, RN · Jul 7, 2013

The order reads, "Hold if SBP

The SBP

If you felt the medication needed to be given in spite of an order to hold it, you would have needed to telephone the physician and obtain an order to give it.

SquishyRN, BSN, RN · Jul 7, 2013

Diltiazem for anxiety??

I'm glad I'm not the only one who thought that. Diazepam perhaps? But then the dosage would be too strong and is in fact appropriate for Diltiazem... Weird.

akulahawkRN, ADN, RN, EMT-P · Jul 7, 2013

Hello,
I am a new grad, LPN and I just working in TCU, night shift. I have a new admid with HIV/AIDS. He is on Diltiazem 30 mg for night time med. In MAR this med is used for Anxiety and it said "Hold if SBP
As others have said, the patient meets at least one of the parameters to hold the med. In particular, the SBP is too low, being 91. As you should know an SBP of 91 is > 105, therefore the parameter is met to hold the med. The HR is OK... it's >60... since the parameters have an "or" statement in there, if either is true, then you hold the med.
You were not wrong. However, you should also be sure that the vital signs are recent enough (per facility protocol) so that you're giving or holding meds based on current information, not old stuff.