Hypertension and Hypotension

[moomin, LPN]

I am a new nurse working at a SNF. I was wondering what other nurses do first if a resident has high BP or a resident has low BP?

[NRSKarenRN, BSN, RN]

Recheck the BP ensuring cuff in correct location; check BP on both arms. Then perform physical assessment, patients symptoms. Check BP record for trends then check med profile to see if any meds held. If BP within patients normal range and asymptomatic, reassess in 1-2hours. If patient BP high out of parameters and patient symptomatic is it time for patient to have BP meds-administer or If BP low --how is fluid intake, hydrate and recheck in 30 min. Patient anxious-do they have anti-anxiety med; can redirection, calm voice and some deep breathing/relaxation be tried.

Notify attending physician if patient remains symptomatic 30-60 min after hydration or meds given. Critically high S> 180- 200+, D> 110-120 and not usual patient high #, symptomatic, no meds to give, call Doc and consider hospital transport, especially if possibility of stroke.

[CharleeFoxtrot, BSN, RN]

^^^what she said LOL. The only thing I would add just to clarify would be to not just look at the numbers hypo/hyper while assessing. Look-and I mean really look at your patient, do they seem unwell? Personality changed? Ask staff who know them if you do not. Most importantly, ask them how they feel and include that info in your SBAR to the physician.