Before posting this I tried searching google and allnurses forums but I wasn't able to find answers to my questions so I hope you guys can help! (What happened to the search function anyway, or did I go blind?)
2 questions:
1) I recently had a pt with BP of 124/48. She was fine, no concerns. However, I haven't seen a dbp that low and asked a fellow nurse when dpb would be considered too low and something to contact the doc about and she said she didn't know and to judge it by how the pt was doing.
I didn't pursue the question because we were pretty busy, the pt was fine, and I wanted to do some research later on.
I know that we should be considered if the sbp is below 80 or sometimes 90 depending on the pt - is there some kind of parameter for the dbp?
2) What was the lowest dpb you have seen and how was the pt doing?
78/44 during c-section of mom with twins with 900 or so ccs of blood lost. They got it up pretty fast.
Listening manual, I've heard 102/40 and patient had a hx of heart disease of HTN -- I was a student, wasn't sure whether to give the calcium channel blocker that is due in such cases but doc wanted it given (based on history and that typically it is held for systolic
Have had 88/68 myself, no symptoms. Have seen those numbers on a patient who was dizzy and puking, so it does depend on the person.
I don't remember the exact numbers but I had a LOL who was 40s over 20s after 2 doses of sl nitro. She was talking to me the whole time--complaining about the BP cuff squeezing her arm!
Specializes in Gerontology, Med surg, Home Health.
My own after being in bed for 3 days deathly ill....80/42 and the stupid nurse argued with me when I said I wasn't going to take the hydrochlorothiazide. She told me it wasn't for high blood pressure, it was for 'water'. Yikes.
I work on the Congestive Heart Failure floor. So we have patients that frequently have very low BPs. The lowest I have ever seen was around 75/35. If you looked at her, you would not think her BP was so low but because she had chronic hypotension due to her CHF, it was causing her to go into renal failure, also. It is also common for us to have patients with pulses that stay in the 40s.
The lowest dbp I ever saw was not even while I was working. It was when my wife was giving birth to our youngest son. The doctor giving her an epidural inserted it right before she went into active childbirth, so he had to administer the medication faster than normal. During childbirth, her b/p went down to 50/20. They had her on 1:1 with an RN for 4 hours afterwards. Luckily, she ended up just fine.
Mine. 66/32 after blacking out. That was actually when I was starting to feel better and snap out of it so I really don't know how low it went...but it felt terrible.
Mine. 60/40 and dropping after epidural. Everything was going black, and I thought perhaps I was dying, which was a little anxiety provoking, to say the least. Woke up later.
91/28 in a patient admitted for chest pain. Patient is normally hypertensive and even came in with a systolic >200 (patient didn't take any meds that day so they rebounded). Normally the patient runs 140's-150's/80-90, so 91/28 was VERY low for them. And the doctor wasn't concerned.....
Mine. 44/16 during a tilt table test- and I was NOT unconscious- not too perky, but still could see and hear the nurse telling me to talk to her....all I could think of was "I really don't have anything to say".
Checked a patient one night (wasn't mine, nurse was on break and the CNA was freaking out because she couldn't hear the BP - kept asking me if she was stupid, bless her heart (newbie) - I just told her she did fine - you can't hear what isn't there!).
I THOUGHT I heard SBP around 50, could not hear DBP...So I supposed that would be a 0. Used a doppler and I think I got 48 SBP. He was septic and moved to the unit. Don't think he survived long.
Apparently I got to 90/50 on a Dilaudid PCA. I remember the nurse saying, "Yeaaaaah, you're gonna have to leave that button alone for a while." Opiate naive? WHO SAYS??
Not a BP, but I met a pt with an EF of 2% yesterday. TWO. Walkie-talkie, pink as could be. You'd never guess it to look at her.
manchmal
61 Posts
78/44 during c-section of mom with twins with 900 or so ccs of blood lost. They got it up pretty fast.
Listening manual, I've heard 102/40 and patient had a hx of heart disease of HTN -- I was a student, wasn't sure whether to give the calcium channel blocker that is due in such cases but doc wanted it given (based on history and that typically it is held for systolic
Have had 88/68 myself, no symptoms. Have seen those numbers on a patient who was dizzy and puking, so it does depend on the person.