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Discussion

I've got a question -Taking BP before giving anti-hypertensives

Just wondering about this. If I were handing out meds to a patient with prior hypertension in a med-surg ward and the patients chart indicated low BP because of the prescribed anti-hypertensives would I be laughed at if I took their BP before medicating? I thought it would be a safer option to do this and even withhold the meds because of the lowered blood pressure. I don't know if I am too cautious but as a new grad I don't want to make any mistakes in the haste to just pass all meds. I mean if the buck stops with us wouldn't this be the best option? Has anyone been in the situation where a persons BP has just dropped way below because either everyone was too busy to take a BP. How many of you regularly check BP's before administering or is there just not time?. It might seem like a stupid question or I might just be naive. I know if someone's BP is really low and the meds are withheld it might be mentioned in handover but what if no-one has noticed.

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I have never given a bp med in any setting without checking the bp first.

You can call the doc and get parameters for holding the med.

I always check a BP before giving an antihypertensive. You're not naive to do it, you're smart! Just make sure you either call the MD before holding a med or you get parameters. :)

We were always taught in school to take the BP beforehand. If you didn't, you were in big trouble.

:typing

:yeahthat:

What they said You must always remember it's your license on the line when you give a med. Don't worry about what others might think, do what you think in right, and what you are comfortable with.

I would definitely call the MD and get perimeters for holding it. Some other questions would be How long has pt. been on med? How often has the B/P been low? Is there anything else in his tx. that can be causing this? How low is the B/P?

Would you give Nitro without a systolic of 100?

Always get a bp.

Agreed, I always check BP and HR before giving antihypertensives and cardiac meds. It's a minimal standard of safety when administering these medications.

We were always taught in school to take the BP beforehand. If you didn't, you were in big trouble.

:yeahthat:

we had a girl kicked out of the program because she gave a bp med with the pt having too low of a reading- she gave it anyway we are ALWAYS required to check it first, and note it on the MAR beside the med.

Yes, yes and always check the BP prior to giving antihypertensives. Many other things in the hospital setting and in illness can affect the BP so someone who historically runs extremely high may run lower. For example, I have seen a chronic severe hypertensive not even need their BP meds in the hospital due to the narcotics on board. SG

In any given situation I would rather be laughed than have the finger pointed at.

what if the patient is *just* above the parameters? would you hold the med?

This is probably a dumb question, but I haven't encountered it yet on my clinical rotations.

Sometimes the LNA's do vitals prior to 7am, and med passes aren't until 8am. I've always checked the b/p again before giving an antihypertensive, but as an RN, do you always re-check even if the LNA just took a b/p? I've always wanted to hear with MY ears (we're not allowed to use dinamaps for am vitals!) what the b/p is, so I do a check even if it was just done by the LNA with a dinamap 15 min ago.

Is this too much? I know checking b/p too much can give inaccurate readings also, but how much is too much?

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