stupid question 1075 - b

We do it all the time. Obviously it was an emergency....what difference did it make?

What if your patient has an arm that can't be used either due to node removal or dialysis access...you will use the same arm as iv access for vitals.

You'll see nurses each have their own systems and reasons for doing things...learn their reasons why, then make your own decisions adding the best fits to your practices and styles.

Maisy

Hey Bigreddog!

Yeah, I do it, as well. I think it's not a problem to take the BP in the same arm as the IV is in (what, if the patient has two IV access sites - one in each arm, by the way) - just remember one thing. The BP cuff will cut the vein off. Therefore, if you have fluids going in by gravity, it will stop. If you have fluids going in by pump, it may not stop. Our pumps can go up to 1200cc/hr, and I frequently use that setting. If you have the BP cuff on the same arm, and the monitor set for automatic BP's, you got to be careful. Nothing has happened to me yet, as I try to be careful, but I have heard of vein blow out. This may not be too bad if you are infusing normal saline, but sometimes you don't.

Just my

Bye for now

Yeah, the only problem I could think of is that you could blow the IV by doing so. I have a tendency to use the arm opposite my IV if I can, out of habit. Sometimes when it's inconvenient to use the arm without the IV I will reach for it, and then half of the time the parents (Peds ED) ask, "aren't you going to use the other arm?". I want to say "NO!" I'll use the arm I want! ...ok I am obviously tired and aggravated at parents right now.

You were totally correct in using the arm with the IV in this situation.

You were totally correct in using the arm with the IV in this situation.

Agree. While it's preferable to put the cuff on the opposite arm when possible, there will be many instances where this is not possible or just not the biggest priority at the moment.

You'll have patients with one arm reserved for dialysis, amputees, people w/trauma to one arm, and many sick patients with multiple lines. In all of these situations, you'll use what you've got to work with.

Don't sweat it.

thanks guys - as a newer nurse im trying to spend a little time figuring the reasons behind some of the simpler tasks, rather than just doing them out of habit. i had a feeling that i wasnt doing something awful; the nurse that told me, "i should know better" has only been an rn for a couple of years herself. thanks again.

The only complication that I've seen with putting the BP cuff on the same side as the IV is that sometimes when the BP cuff inflates, it forces blood back into the saline lock (if fluids are not running, and the saline lock is not clamped).

Generally, I place the pulse ox on the same side as the IV, and the BP cuff on the other side. That way the monitor isn't beeping "low SPO2" when the BP cuff inflates. But like everyone else stated, there are extenuating circumstances.

If your IV is running KVO, then it can become a problem. The BP cuff can cause blood to back up and may indeed clot your line off. I've seen it about a gillion times and had to restart IV's on the unstickable. The smaller the gauge the more apt it is to clot off.

Well first off, what do you mean you got "scolded" no one should be talking to you that way. I'm really getting burned out by the unprofessional way some of our fellow nurses treat each other. There is just no excuse, I don't care what is happening; it's a power trip "I'm better than you" Did she be-little you in front of the Dr or Pt? If so shame on her. I've had some pt's where the only place for a b/p cuff is above your ONLY and LAST IV site which in fact might have Levo running through it and the Icu residents are slammed and can't put in a central line for ya. Scary. One b/p above an IV shouldn't make a difference.

yeah i was scolded. to be honest i think the nurse that did so didnt know that there wasnt anything really wrong in what i did because shes only got a few months experience more than i do.

what occurred was that she tried to use the iv and thought it wasnt working, which turned out to be absolutely fine and used throughout the intubation. the whole exchange just seems unnecessary looking back on it. i just wanted to find out what, exactly would be the reason not to place a cuff over the iv because, like its been mentioned here, i could only deduce a few minor reasons.

i am sure the opportunity will arise where i can eventually correct the nurses understanding of bp cuffs and iv lines. until then ill just live and learn.