nitro drips

[gonzo1, ASN, RN]

I got in serious trouble last week while working in the ER for letting a pt on a nitro drip ambulate to the restroom with assist. Pt was not an MI and had stable vital signs since coming into the ER.

Do you ever let your patients that are on a nitro drip get out of bed? Usually I don't, but this pt was young and very stable.

[carolmaccas66, BSN, RN]

When I worked in cardiology patients were never allowed to ambulate even with assistance.

Think about the reasons why. Nitro is a VERY powerful vasodilator, even when titrated to the patient's particular circumstances.

Just ask re your facilities policy next time.

Why was he on nitro if he had not had an MI - did he have a cardiac history?

[gonzo1, ASN, RN]

Thanks for the info. It was the tech who actually let him get out of bed, but I was going to let them continue to the bathroom since he was already up. I need to study up on my med precautions.

[EDrunnerRN]

I dont know all the details but if a Nitro drip is involved I use a bedpan. One of our hats is to keep the patient safe. Any cardiac complaint gets a bedside comode and if drips are involved or the patient continues to c/o CP stick to the bed pan. You can never be overly cautious with these ones. Acuity 3's and below I tend to use bedside comodes/bedpans.

[usalsfyre]

Postural hypotension is common with NTG, hence the high fall risk. Just as a thought, was he voiding or having a BM?

[gonzo1, ASN, RN]

voiding

[nurse2033, MSN, RN]

If the patient didn't have a problem, then there wasn't a problem. I would be very cautious letting such a patient out of bed, but if you assess their ability to ambulate then I would have done the same. The idea of blindly following policies for their own sake discourages critical thinking.

[sunnycalifRN]

Our post-op day 1 hearts are almost always on a nitro gtt and we MUST (or the surgeon will scream at us) get them out of bed to the chair. Granted, the dose is usually minimal. It's usually a two person job until we know how stable the patient is on his feet.

[carolmaccas66, BSN, RN]

Even patients on telemetry when first admitted to the cardiac/renal ward were not allowed to leave the bedside. We used to put a commode there or use a bedpan, but they need to be watched and monitored. Later on, they could ambulate if they became stable, but I used to go to the toilet with them.

You can't be too careful!!

[brownbook]

I vote for nurse2033 and SunnycalifRN. I hate not being about to use my own judgment. Have the patient stand at the bedside. walk in place, walk with them to the bathroom. Obviously your young man made it to the bathroom and back okay!!!!!