Questionable parameters?

untamable07 · Oct 15, 2008

I am a student, graduating May 2009, but no I wouldn't. We are taught it has to be over 90. 85 is close but not close enough to medicate. Hope this helps.

untamable07 · Oct 15, 2008

Sorry I thought you meant diastolic.

morte, LPN, LVN · Oct 15, 2008

there may be good reason for this, ie very diseased heart...

UM Review RN, ASN, RN · Oct 16, 2008

No, I wouldn't.

morte, LPN, LVN · Oct 16, 2008

what is the background on this patient?

GLORIAmunchkin72 · Oct 16, 2008

I don't understand why the doctor would not change the parameter to a higher systolic number. He has been questioned about it twice.

UM Review RN, ASN, RN · Oct 16, 2008

Some docs want the patient to have a beta blocker to help the heart function and will give Coreg 3.125 with parameters to give with a BP of over or equal to 85.

However, I would expect that the patient would be in the Unit where someone could immediately reverse a systolic that was going too low. Floor nurses generally have too much to do and cannot continuously monitor a pt's BP as well as the CCU can.

morte, LPN, LVN · Oct 16, 2008

Some docs want the patient to have a beta blocker to help the heart function and will give Coreg 3.125 with parameters to give with a BP of over or equal to 85.
However, I would expect that the patient would be in the Unit where someone could immediately reverse a systolic that was going too low. Floor nurses generally have too much to do and cannot continuously monitor a pt's BP as well as the CCU can.

perhaps the patient is DNR....and the OP, why not ask why instead of for a change, after all it is the doc practicing medicine not ye

Altra, BSN, RN · Oct 16, 2008

Is this a renal patient? If so, it may be appropriate to give it.

GLORIAmunchkin72 · Oct 17, 2008

I'm beginning to feel a little better about this order after reading your answers. Some doctors don't like to be second-guessed and some don't like to explain. I would still have a hard time giving the med if the actual systolic number is 85 because it could very well drop to 80 or 75, barely enough to sustain life.

Kymmi · Oct 17, 2008

Most doctors dont like to be second guessed or have to explain however that is their problem and not mine. If they are asking me to do something and I do not understand their rationale they are going to have to explain and convince me why it should be done...if they can't do that they can find another nurse to do what they can't explain or they can do it themselves.