Question about BP parameters for antihypertensive meds

[T.Dix.Nurse]

Hi to all cardiac nurses,

I'm just curious about this. I'm fairly new as a nurse.

I've been encountering BP meds so far that has systole-only parameters. for example; Lisinopril, do not give if systolic is

Then on a certain shift, I got 112/40-sh for a patient. She has Lisinopril, do not give if systolic is

I got worried about the diastole being on 40 but my other co-nurse was saying it's okay to give it because the systole is okay. Then a co-nurse questioned me why I didn't give it knowing systole is not below 100. I said I'm not comfortable administering it because diastole is low.

I'm new to my job place and this is my first hospital I encounter that doesn't set parameters on diastole.

My question is: Is diastolic not as important than systole anymore?

[RN403, BSN, RN]

Too me, diastolic is important as well. If a patient has a diastolic in the 40s I will call the doc if there aren't any parameters and inform them of the patients current BP and HR and baseline and allow them to decide if they still want it given or not. I still see parameters at times which pertain to the diastolic number which leads me to believe it would still be important.

When in in doubt call the doctor and clarify. You can always ask for parameters for a diastolic number as well which will help prevent multiple calls by multiple nurses to the MD later.

[blackvans1234]

Calling the doc is always the best thing (assuming you document it).

If for whatever reason impractical to call, you could always look at the trend of vitals. If the patient's diastolic is always 40s then I wouldn't be as anxious (not that the aforementioned logic would hold up in a court if something went wrong)

[kool-aide, RN]

Is this a cardiac pt? Stemi or nstemi with known heart failure? If so, they probably don't really care about the pts DBP. If the pt has HF they need the beta blocker to prevent remodeling post MI and for negative inotropic effect and they need the ace for afterload reduction.