CrazyheadSN

Thank you all for the replies. I have definetly learned a valuable lesson. I did hear back from my instructor and she feels that my mistake is OK. Though, she still wants to talk to me about my worries bc I have worried about other things in the past such as- causing hypoglycemia in a pt., etc. I get really worried about my patients. My instructor is there to check off the IVP med (we go into the pt.'s room together) but she is usually not there when I actually give it. She might be there for the first flush, and MAYBE when I start the med IVP, but the instructor does not stay for the entire push. She usually leaves to go to another student. I think a lot of my worries has to do with not being supervised more. I am debating if nursing is for me. My instructor feels that I may not be able to enjoy the profession if I feel this way often....Ughhh...I feel like I really don't want to work in a hospital! Mainly bc I don't want to make a mistake. So I think I strive for perfection and no one is perfect... :uhoh21:

Being that it was 45min after the IVP do you think that her BP would drop anymore than 139/93? I looked up the peak of hydralazine and I believe it was 30-45min...I feel really sick to my stomach over this. I could have done some serious harm...And I'm now wondering how the pt. is doing.......

Thanks for the reply MJB2010, I do have to tell my instructor before giving a PRN med. I told my instructor the pt.'s bp was 166/93 and she had a PRN of hydralazine for SBP >160. Though, my instructor did not know I was taking the BP on the forearm. I didnt even think twice when I was taking it on the forearm....

I'm a student. I was in my last Med/surg rotation (telemetry floor). I went to get pt. vital signs in the morning and she wanted her BP taken on her forearm. So, I did. She said it was due to her very large arms and it pinched when you take it on her upper arm. I got a BP of 163/87 (dynamap). BP was slightly high so I wanted to give her 9AM meds which included some BP meds before any other intervention. I administered her medication and I went back at about 1130 and did her VS again and her BP(forearm-dynamap) was 166/91 this time. I checked her PRN and she had an order of hydralazine 10mg (0.5ml) IVP. So, I administered the hydralazine @1245 IVP. I went back around 130PM and took her BP on her forearm. It was 198/100. I was thinking OMG how the heck is it that high after administered her hydralazine. At the time the nurse was coming into the room so I showed the nurse the vitals on the dynamap. The nurse questioned it and thought "that's not right." I told the nurse I was taking her BP on her forearm because the pt. felt like it was more comfortable. The nurse found a larger BP cuff and took the BP on the upper arm. BP this time was 139/93. Nurse said, "that's better." and that was it....and I went home. Soooo, basically, 3 days later I'm freaking out because I could have caused my patient's BP to drop. I was probably getting the wrong BP reading the entire day by taking it on the forearm, and then I go and push hydralazine!! I feel so bad about doing that. Here I thought, I'm doing great in clinical, and I go and do this.......I emailed my instructor b/c she doesn't know what happened and I didn't really worry about it or even THINK about taking the BP on the forearm as a big deal, until now. Could 10mg (0.5ml) of hydralazine really cause my patient's bp to drop to the point that she could die? I feel so bad......I think I might get kicked out of school b/c of this mistake......I'm waiting to hear back from my instructor....