eaetaylor

Now that you say that, I find it to be true. I know in my facility we worry about a SBP that is too elevated, but are concerned about perfusion if the MAP falls below 60.

Yes, she did get CPR the first time. Thanks for your input, that helps!

So I'm coding a patient that has had an acute MI, is in renal failure and currently has an ejection fraction of 10%. She had just been through a code no more than 1.5 hours ago, and when blood work was done in the first code, her serum potassium was 5.2. When we coded her again, another doc responded to the code and requested another serum potassium level. This one came back at 7.2. He stated that was her problem (even though this was the SECOND time we coded her). Is it possible that her serum potassium was only elevated due to her being down so long in the last code (40 minutes) that her RBCs began to catabolize, in addition to her decreased kidney function? I guess my question is: Could the potassium level have been the RESULT of the code and not the cause?

I, too, got into ICU/CCU right out of school, and I've never regretted it! Like others have said, you never stop learning and you can take the experience anywhere. Good luck in whatever you choose to do!!!

When working in the ICU, we are always sure to monitor a patient's MAP, and work to keep it above 60 to ensure proper vital organ perfusion. I was wondering why, we as nurses (and doctors) are so wrapped up in only systolic BP? We titrate medicines such as dopamine and neosynephrine based on SBP parameters. I was wondering why diastolic pressures are not thought of as importantly? When calculating a MAP, I found that a BP of 120/80 gives a MAP of 93.3 mmHg. If the systolic is changed by 10 to a BP of 130/80, the MAP changes to 96.7 mmHg. BUT, if the diastolic is changed by 10, to 120/90 the MAP changes to 100.0 mmHg. It only seems logical to me that we should be equally concerned with keeping their diastolic pressure up as their systolic. Am I missing something? I'm fairly new, so any education would be helpful. Thanks!

Actually asked an endocrinologist about venipuncture vs. fingerstick. He told me that the blood glucose levels would not be as accurate, especially if dealing with edema. I would believe that would apply for K+ levels, also. According to him, the venipuncture would almost always be more accurate.