Intro and question...

MargRN, BSN · Feb 9, 2004

and he said that he had an appt to get his abdomenal aneurysm checked for size changes. He called to report his BP which was 160/90 today. Still not great.

I hope things improve for him. At least, he's getting a good check up.

zacarias, ASN, RN · Feb 9, 2004

It seems strange that they would allow your father to have such high pressures for any amount of time with this abdominal aneurysm!

Toprol is a good drug but maybe he needs to try adding a different kind of drug also to that beta-blocker. His pressures need to get down though.

Let us know any developments.

MargRN, BSN · Feb 9, 2004

but I think he was just started on HCTZ diuretic too. That is important to note too. duh!

I have no clue what his BNP is. I didn't know he had any CHF.

I hate guessing about family when we know bits and pieces. KWIM?

Thanks for your reply. The aneurysm has bothered me and I don't know much about them. His primary physician was never concerned with it but re-checks it twice a year. It's never been a concern to the MD.

Also he is getting his carotids checked for what percentage is occluded. Why do they wait until it's like 98% occluded before doing anything? :eek:

Just my thoughts...

RNPATL, DNP, RN · Feb 12, 2004

Hi!
I'm Marge and I'm mostly a SAHM (stay at home mom) but work per diem at our small hospital's 20 bed Med/Surg unit. I really like the RN registry!
I used to work Oncology which is where I wanted to be and got on at a large hospital FT straight after nursing school. (May 95) Then after our first child was born, I went to public health nursing. (wanted a matching schedule with my DH) Then stayed home with children for a few years. :)
HERE'S MY QUESTION (not yelling - just caps)
My dad has a history of Hypertension but it's been controlled via po meds. Last week we were visiting and I listened to his BP which was 184/94. He was taking Toprol XL 50mg. He ended up in the ER that night b/c he didn't "feel right". (He doesn't just go to the MD or hospital unless he really thinks he must.) All EKG and all-night telemetry monitoring were fine. He was DC'd home the next day on Toprol XL 100mg and a new RX for Lipitor.
Then 2 days later he goes to get his BP checked and it's still 190s/upper 90s and MD increases Toprol XL to 150mg for 3 days (Friday thru Sunday/today) and instructed him to then start taking 200mg QD beginning tomorrow.
Does the 200mg seem high? I know I've had patients receiving Toprol XL. And I know it is prepared in a 200mg strength.
I think I'm just worrying too much. He denies chest pain or dyspnea - just a "weird feeling". He also stated his legs felt "rubbery". I know Dad takes a fair amount of OTC Motrin too. My info states that Toprol may be affected by NSAIDS.
I just hoped to have some "experience" input while I feel like I'm relying on "book" input.
Thanks in advance!!!!!!
:)

Marg - you have every right to be concerned and question what the physician is ordering. Given the little bit of information you have told us here, it might be a good idea for you and your dad to schedule a consultation meeting with his physician and discuss his current issues and your concerns. As an RN, you have the ability to "feel" when things are just not right. That gut feeling comes from experience and any nurse worth his/her weight, knows this is true. If your dad says he feels funny, then he probably has something going on that needs to be addressed. I don't have enough information to give you my opinion, but 200mg of Toprol XL is a lot of beta blocker. Many patient with HTN and other etiologies benefit from combination therapy and perhaps this is something that you want to discuss with your dad and the physician.

I have my own cardiac history and I have to tell you that if we do not advocate for our own health care, the physicians are not going to do it for us. As an RN myself, I did a lot of research on my illness and went back to my physician and discussed ALL my options with him. He agreed with most and disagreed on some. I respected that fact that he sat down with me and took the time to hear me out and explain what my treatment options were. Today, I feel better and am very productive. But I fear if I had not sat down with him, I would have been nothing more than a number to him. We must advocate for ourselves, for our family and certainly for our patients. If you feel concerned about your fathers treatment plan .... discuss it with the doc (with your dad's permission, of course). If his physician does not make you feel a little more comfortable .. get another opinion, from a physician that you can trust.

Take good care and good luck. I hope your dad feels better.