Blood pressure medication / checking blood pressure

  1. Hello I am currently learning all my pharm about blood pressure medications (student) and am wondering since my time spent on a ward that not many people check blood pressures prior to administering morning blood pressure medication.

    I am sure there is a reason for this, I am just wondering if there are CERTAIN BP medications that drop the BP or elevate it quite substantially and quickly that woudl merit a BP check prior to giving. Kind of like a PR check with Digoxin before administering.
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    About abeautifulmind

    Joined: Mar '12; Posts: 2


  3. by   LoveSbux
    On my unit, morning vitals are done between 0700-0730; BP meds are usually scheduled for 0800 (coreg is usually given with food) or 1000. If the patient's BP or HR is close to the cutoff (there are parameters entered by the doc usually) then I will recheck prior to giving meds.

    The parameters depend on the patient; HR cutoff is usually to hold if lower than 50 or 60, and BP if lower than 90 or 100.
  4. by   abeautifulmind
    So are there certain BP medications/ classes to be aware of though that would drop the BP quite quickly that should be checked religiously with last recorded BP
  5. by   MattNurse
    I work in acute care and take a blood pressure and pulse immediately prior to giving any drug that would change the patient's blood pressure, including drugs like morphine. I know in long term care if you are working in that area the patient's can sometimes only get a set of vitals once a week and receive medications. I will use vitals if they are 30 minutes old if the CNA has taken routine vitals, otherwise I just take a manual BP.
  6. by   wanderlust99
    You need to check BP & HR before giving any BP med....end of story If it's a cardiac med, I'm checking. So any beta blocker, ace inhibitor, etc... it's pretty imporant. Also check BP before giving diuretic. Maybe they were looking at the VS taken by the tech?
  7. by   psu_213
    My guess it the looked at the BP taken that morning by the tech. One other thing to remember, if a person takes BP meds at home they likely take it every day without ever checking their BP. Now, if the pt falls below a parameter written by a doctor, don't give the med. However, it may be worth a call/note for the doctor if the person is regularly falling below that parameter and not getting the BP med they have been taking at home for years.
  8. by   tokmom
    I always take a set of VS (minus temp) prior to giving bp/cardiac/diuretics. It's our policy to do it for the first two meds. It pulls from the most recent result, but I take one anyway. It's simple for me...CYA.
    Yeah, these people might have taken them for years at home, but now they are in the hospital sick. Secondly, I'm responsible for them while they are under my watch.
    Last edit by tokmom on Mar 25, '12
  9. by   0402
    If the most recent tech's BP is more than 1 hr old, I do it myself. I work nights, and where I work right now, vitals are usually done around 2300, so if I'm giving an HS bp med, I'm going to check, myself, before giving it. I'd rather have them get their bp checked a few extra times than have them bottom out.
  10. by   turnforthenurse
    Rule of need to check the HR & BP for every BP medication, no ifs, ands or buts.
  11. by   FutureRN_NP
    You need to check BP prior giving BP med. There is no way around it. I always do mine to ensure I do what I am suppose to do. Oh when a tech tells me I never have to take this pt's vital prior these X,Y, Z nurse give med, I get irritated. First of all I am not these X,Y, Z nurses. Do it or else!
  12. by   traumaqueen36467
    I am a new nurse and I recently started working in a long term health care facility. Some medications on the MAR have directions to hold if B/P is < X. The CNA's usually don't report the v/s til the end of the shift unless the readings are abnormal. When you have 30 residents or more receiving medications multiple times during the shift how do you CYA by checking the v/s yourself and still be able to administer each medication an hour before or after their prescribed time, plus charting and everything else? Any pointers on how to build time management skills regarding this?
  13. by   Kasandra
    You can always invest in a portable b/p cuff that goes on the wrist. I would take the b/p before cardiac med passes to ensure that the patient's baseline has not changed (and trust me: It can, and does, change).
  14. by   FLmed
    I am baffled when I see nurses giving BP/cardiac meds without getting a recent BP and HR assessment. We all worked hard to get our licenses and it can easily be taken away if we aren't being safe. Remember that even though people do often take their BP meds at home without taking a BP, that's on their watch. When you have them, they have been admitted into the hospital because they are sick. It's now on your watch. It doesn't take that much longer to slap a BP cuff on.

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