Labetalol policy for PIH

[anggelRN]

We have had a lot of pts with PIH or chronic hypertensives on our labor unit lately. We have been pushing a lot labetalol lately and we do not have any specific policy. We recently decided to have all our pts cardiac monitored. Anyone with any specific policies they would like to share is greratly appreciated.

[TREC96]

Hi I work on a labor unit and most of our patients are preeclamptic, hypertensive.... I have never seen a policy on such either. as for monitoring them we do serial BP's and not much else unless they are on mag then mag levels are taken every 6 hours

[LouisVRN, RN]

Cardiac monitoring? I think that's a bit excessive for most patients. I think unless the patient becomes unstable blood pressure monitoring and monitoring of heart rate would be sufficient.

[Do-over, ASN, RN]

Not in OB (Cardiac Step-down) and almost all of my patients are continuously monitored... In my setting, I would not push any "cardiac" med unless the patient was on a monitor.

[0402]

I work med/ surg, and we can't give IVP labetalol unless a pt is on tele. It's SOP for us.

[Elvish, BSN, DNP, RN, NP]

OP - do you mean 'pushing' Labetalol as in 'encouraging its use' or as in 'IV push'?

Just for clarification.

If it's PO, then I agree that cardiac monitoring is a bit excessive. If IV, then I agree that it should be the norm. I don't think we give IV Labetalol on my unit....only hydralazine.

[babyktchr, BSN, RN]

Cardiac monitoring should be done on patients who are receiving IV Labetalol. I would imagine most facilities would have a policy on that given its mechanism of action. PO it is not necessary

[RNLaborNurse4U]

We do a minimum of 2 hours continuous EKG monitoring when giving Labetalol IV push. That's two hours after the last dose is given -- so if I give several doses, it starts before I push the first dose, and ends two (or more) hours after the last dose is given.

PO labetalol - no cardiac monitoring. Women take po labetalol at home and aren't monitored either.

We also give hydralazine IV, but no cardiac monitoring for that (less problems with dysrhythmias r/t hydralazine vs labetalol).

[stillwaiting123]

I work in postpartum and we are allowed to give labetalol IV up to 3 times, but if it still isn't helping by then, we are supposed to get an order to transfer them back down to labor and delivery so than can receive more and be monitored more closely.