NoobRN

so similar situation happened, this pt had cad, htn, dm, a.fib, dialysis w/ckd and on carvedilol 3mg, amiodarone, and hydralazine 100 mg and bp ~120/48, hr 80 at the end of the shift. Gave first two except hydralazine thinking pt prob needs carvedilol and amio for a.fib, held hydralazine thinking it could dropped too much and confirmed this with md. When i returned and got report, night after i left pt's bp dropped to 96/38 ?. I still think it was right choice but I don't know why pt dropped so much..

so this pt is in med surge unit, and don't remember everything but pt was on those two medications for some time and hx wise pt came in for pressure ulcer. Pt's vital signs seemed to be within that range but diastolic was lower than usual and last time I talked to pt before medications, pt seemed stable.

oh....so even though diastolic maybe <60, if systolic is high (>120), we still treat it? then if systolic is little low (e.g ~100) and diastolic low as well (e.g. <60), then that's when we have to hold if no parameter present? do we have to consider map if this is the case where both are low? sorry Im getting little confused and my critical thinking is not solid...

Among many blood pressure medications, are there medications that specifically lowers systolic more than diastolic or vice versa?

well I didn't know it either but found after googling that isolated hypotension is when blood pressure, usually diastolic hypotension, is < 60 while systolic is normal or above the normal (e.g. > 120).

Im a relatively new nurse and still confused about when to hold blood pressure medication. Most of the patients i see have isolated diastolic hypotension bp ranging like 110/54, 135/55, etc etc. One patient i had was at the end of the shift had scheduled hydralazine 100 mg tab and carvedilol 12.5mg and her bp was 141/51 hr ~70s. I asked my preceptor if it was safe to be given as well as supervisor and they said yes. I was confused because I learned/heard usually if sys <90 and/or diastolic bp <60 we have to hold blood pressure medication and I feel like I should've held this medication but ended up giving them because they said it was ok to give. Can someone explain to me what I should've done in this situation? also, if pts have isolate hypotension and have more than 1 bp medication, what is the right thing to do? -thx

just checked spam mail..nothing but fake mails about miracle pills...my guess is either they are overwhelmed by amount of workload they have to do or there's nothing really for us to do in the 1st week....darn it someone please give us new information!

will be at seton hays.....anyone got accepted there? seems this post is less lively than other seton residency posts from pasts...

Hi everyone! I just got an offer e-mail from HR too, nice to meet yall!