Pain management w/ low BP

[NurseCherlove]

Hi! Gotta question for you pain managment nurses....

Well, first hear the scenario...

A few months ago, my friend at work (I work on a M/S unit - always lots of pain issues!) was VERY frustrated. When I asked her what was wrong, she told me that one of her patients was getting really nasty with her b/c she wanted I think it was percocet and phenergan and my friend did not want to give them to her b/c her BP was already VERY low. I think the lady had also had some PRN morphine or dilaudid earlier possibly? Anyway, the patient ended up "firing" my poor friend.

Now, know that my friend has been a nurse for 20+ years and she really does have excellent nursing judgement. Being a relatively new nurse, I go to her first with all of my questions. Anyway, my poor friend was running around, calling docs, and getting a bunch of conflicting info. and also some of the docs did not even want to address the problem!

I suggested IV toradol, but the patient had kidney problems. A nephrologist (not on this patient's case) also happened to come into the nursing station and when my friend asked his opinion, he joked and said to give the patient something at the end of her shift!

I never did find out what ended up happening. So my question to you guys is...What would you guys have done in this situation (this patient had multiple co-morbidities)? What are some effective pain meds that only have neglible effects on BP?

Thanx in advance for your responses!