Published Jul 14, 2013
trutuyu
47 Posts
I am a new grade just off of orientation on a telemetry floor. I had a patient come in with a SBP in the 190's with a HR in the mid 40's. What's the intervention?
bfbabs
2 Posts
The patient needs something to lower their BP without affecting their heart rate. I find when they first come to the floor from the ED they usually haven't taken any of their daily medications so I would give this patient all of their meds but you definitely want to check with the LIP before giving any Beta Blockers or Digoxin.
turnforthenurse, MSN, NP
3,364 Posts
Did you take care of this patient? I'm curious to know what YOU think or what you did. What about your preceptor?
medic0681
33 Posts
Hydralazine IV. will increase HR and C/O while vasodilating & decreasing BP
I honestly didn't know what to do. Other than a high BP and a low HR the patient wasn't showing any other symptoms. So I called my charge nurse. We waited five minutes then retook the VS. the BP dropped after the patient was settled into bed for the night. But thank you medic0681. I won't forget that in the future.
ChristineN, BSN, RN
3,465 Posts
Agree with this. Hydralazine is always the IV BP med of choice if you only want to lower BP and not affect HR. I would also look at the bigger picture and try to figure out WHY the pt is hypertensive and yet brady. Is the pt just in a sinus brady or are they experiencing some other arrhythmia