so I had a new ordered prn hydralazine IVP q6hr for sbp greater that 170. The BP had been in the sbp 200's for almost 24 hrs. Prior to giving this medication, I checked with another nurse (ctl/charge) about the medication,administration, etc, just to double check myself, the bp had already been taken by the aide but I obtained it for myself right before giving the med. Education was given on the medication and the potential side effects all while hooked up to continuous pulse ox/bp/hr monitor at bedside, the med was administered very slowly and heart rate and bp did exactly as expected. I hung right outside of the room after giving the medication to monitor for side effects, about 40 min later complaints of dizziness, lightheadedness, fatigue, BP was upper 80's/upper 40's, called the charge nurse in with me to assess along with me, already had O2 on ,called the MD bolus was given which brought the bp back up to the upper 130's/140's, still complaining of malaise and the same HA she had the last 3 nights in a row prior. continued to monitor all night, BP jumped back up to 170's in the middle of the night and decided to retake manually since the automatic kept repumping itself at the time. bp was in the 130' 140's all night which is way better than 200's. everything was documented accurately in a note as well, and my charge nurse and another experienced nurse said I did fine after feeling anxious about the whole thing,but I still feel anxious about it all even though I didn't mess up, I guess you cant make everyone feel better at every single moment and its something that I will have to get used to as a new nurse, plus us new nurses have this false sense of paranoia I guess(oh the nerves), any thoughts for a new nurse? words of encouragement?
Calm yourself my friend!! You dominated the whole situation... Rest easy knowing you did everything right!!
You can't beat yourself up over the medication doing its job, VERY well apparently. You handled it, you got help from the charge, you notified MD and you documented it all in what seems like a detailed manner. Deep breath!
Curious, how much did you give the patient IVP to cause their pressure to drop so significantly? She probably felt like crap because she had been living for so long with a SBP in the 200s and then her body is shocked when she it the 80s. You did nothing wrong, if anything the IVP dose should've been smaller or she was unexpectedly sensitive to the drug, in either case it was nothing that you personally could've changed.
You definitely did everything right. Was the hydralazine by chance given around the same time as her scheduled BP meds? I only ask because I have never seen hydralazine drop someone that many points... especially just 10mg, but everyone's body is different and every patient will react to medicines a little differently.
I feel like IV hydralazine may as well be saline for most of the people I have given it to.
Nah it was not given after scheduled bp meds, metoprolol was not due for a few hours which does more for HR than bp. Thanks for the encouraging words and input! Makes me feel much better!
<3adventure
22 Posts
also was it good that I documented everything in my nurses note(such as what was done, etc)?