Low pressure at night

kmoonshine, RN · Jul 3, 2008

Was she on a PCA? Getting pain meds? That can sometimes drop your blood pressure. At rest, your BP is going to be lower; perhaps the diarrhea, coupled with opiate pain meds caused a low BP?

locolorenzo22, BSN, RN · Jul 3, 2008

I'd go anywhere from a normal drop in pressure...due to sleeping...to a problem with circulation/blood leaking out from the surgery, etc....Did you get the pressure last? Or did you wake her up, slap on a cuff, and take a BP..I saved BPs for last after I woke someone up, just because I needed to make sure I got as accurate a reading as possible....

AMarie85 · Jul 3, 2008

I don't think she was on a PCA... And I absolutely had trouble waking her up... I really couldn't, she slept right through me getting her vitals.

patwil73 · Jul 3, 2008

You are right! Little information makes it very difficult.

You say no PCA, however was she getting routine narcotics with prn's? Did she get a sleeping pill?

The arousal difficulty is worrisome to me unless we can pinpoint a cause.

As for the rest - I have never seen blood given with a normal H&H unless they were sickle cell. Transient hypotension could be anything from normal dips in sleep cycles, to narcotics, to TIA, to PVD, to sepsis, to etc.

Without any further info, my first guess would be narcotic induced hypotension combined perhaps with sleeping or antianxiety meds.

Sorry wish I could be more help

Pat

Virgo_RN, BSN, RN · Jul 3, 2008

Did she have a history of CHF and was she on any antihypertensives?

CABG patch kid, BSN, RN · Jul 3, 2008

I was thinking something along the lines of the pt receiving an antihypertensive at bedtime (I have quite a few who take something BID or TID that will make a dose due at bedtime). That would explain a low BP at midnight, but doesn't explain her getting blood. I've had pts that were hard to wake up just from the lack of decent sleep that comes with being hospitalized, so its hard to say if the low BP is related. Hard to figure out without more info

mpccrn, BSN, RN · Jul 3, 2008

i'd guess beta's given her age......a sleeping pill at bedtime, maybe a few narcs for post op pain.....i wouldn't worry about it too much since everything else seemed to be ok (her heart rate must have been ok or you'd mention it). it's obviously cyclical....how was she at 0400?

lpnstudentin2010, LPN · Jul 3, 2008

No ideas here on what might be happening but just wanted to say, the same thing happens with me.

Everytime I am hospitalized at night my bp PLUMITS it goes so low that the nurse comes is freaking a little bit. I sleep right through everything until she is on her (usually) third attmept to get a good bp at which time she generally wakes me up. I sleep throught everything else. Temp, first couple of bp's and it is not until she wakes me up perpously that I wake up.

I now tend to warn my nurses before I go to sleep that this is a pattern with me that I have noticed in the past.

Only time anything bad has happened with me at night was one time apparently something happened with my breathing (not exactly sure what) because I woke up with an oxygen mask by my face blowing air past me.