LifelongNursing, ADN, BSN, RN 889 Views
Joined: Aug 9, '17;
Posts: 21 (43% Liked)
; Likes: 28
It depends on how much the hydralazine and clonidine dosing were. Just because a patient says his BP normally runs at 170/90 does not mean we, as nurses, cannot or should not have a tigher blood pressure control in our patients. Outside of orders to keep a certain high level of systolic, we should get that Bp down under 160 systolic. In fact, if the patients bp is 170/90 normally, the patient nor his primary care provider are managing his BP adequately and would have been a perfect time for education.
One hour after giving his clonidine would be a perfect time to check the blood pressure.
Hope that helps!
I would listen
My wife and I are long-time nurses and have worked a number of different jobs with different patient populations, all of which were learning experiences for the both of us. One common theme we have noticed is the nurses' ability to voice their concerns. Nurses are very vocal and in this day and age, being vocal in the healthcare setting is important but it is how and when we are vocal that is most important.
According to Andriakos (2017), relishing the joyful moments in life by drawing attention to them through speaking about them become important in increasing our happiness our lives and decreasing the effort it takes to do so. Spreading some cheer by intentionally brightening up and being vocal in the workplace can go along way. Smiling just for 10 seconds can improve your mood almost instantly (Andriakos, 2017).
This concept is just as important to understand when being negative or being vocal in a negative way. For example, many of us already understand and think of the above paragraph as being motivational and a good way to bring yourself to being in a good mood. However, not many of us realize this works the opposite way as well. Of course, we do not walk around the work place thinking "I wish I was in a worse mood, I think I'll frown for 10 seconds to worsen my mood almost instantly."
It is human nature to find ourselves feeling blue or angry often over situations we almost have no control over and when we voice those situations, we draw more attention to it, and unknowingly began to spread the negativity and "de-cheer" many people who overhear. In each of the work places my wife and I have had the pleasure of working, there seems to be a very familiar trend. The nurse that is vocal about negative events in their personal life, their patient they just had that asked a "ridiculous" question or the family member of a patient that was being unnecessarily difficult. Being vocal about these negative interactions often come up at the nurse desk or other common areas that employees gather to perform their job. Overall these negative conversations not only can put the nurse speaking about it in a worse mood but also the person the nurse is having a conversation with, as well as, possibility de-motivating staff (Ho, Delin, Kin-Hung, Chan, & Lee, 2015).
It is easy to have conversations to make yourself feel good about a situation or to bring attention to a particular event inside (or outside) the work place but do so in a positive way. Nurses today are role models. We are taught that both in nursing school and after graduation, however, some forget that. Being a role model is important to ourselves, our co-workers, and more importantly our patients (Ho et al., 2015).
Being mindful is step one in being the best role model possible and it starts with you, the nurse. Spreading our joy to others through positive motivation, exemplary actions, and choosing how and when we relate a negative situation or idea can reduce the impact of the negativity thus increasing happiness and motivation in the work environment. Be positive! It is important that we all learn from each other and our patients on how to be a nurse and how to treat others respectfully while still voicing our concerns.
At this point there is no need for further action, only a learning moment. Based on the dosing, if the patient had a 167 systolic, and the order was for 20 mg IV hydralazine, you could
1. Give the 20 mg hydralazine and see how it affected the patient
2. Held the order and get a new order for 10 mg IV hydralazine instead.
Typically doing option one is more beneficial, as you could call the practitioner, and say that you've tried option 1, and it was too much, that you thinking lowering the dose would be better.
You shouldn't get into trouble, there will be PLENTY of future cases where you would not be giving an ordered medicine
Glad you are into nursing!
I do not personally participate in the "cosmetic" side of nursing, however, I do know from personal experience that many who do, enjoy it. With that said, I think it is important to point out that often these types of businesses want you to "sell" or "upgrade" a patient's procedure, leading to a possible conflict with the ethics within the nursing field.
Certainly, pursue your passion, just remember to do no harm!
Maybe not illegal but certainly may introduce certain situations where this is unethical. She cannot possibly recommend the flu shot to each and every person on any sort of social media without first knowing each person's background, medical history, etc. At the very least, I would say this is not a good idea generally on social media without giving a disclaimer of "always ask your primary healthcare provider" etc.
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