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?
Mine! I was exhausted for about a week, had orthostatic hypotension and felt like I was going to faint all the time. Finally dragged my sorry butt to the doc and my bp was 50/30, HR 43. Turns out I had adrenal insufficiency.
Yeah lowest I've seen was 34/16 on a med surg unit because pt was dnr. Pt had adrenal insufficiency and was s/p fall with brain bleed she wasn't ambulatory but was A&O x3
When I was having an epidural with my first son my bp dropped from 200/110 I had PIH to 80/30 I felt horrible and promptly threw up.
Last night my patient had a BP of 42/29. And still completely alert and talking with me! Stated they were just tired (because it was 0400 and poor thing, we were in there A LOT waking them up throughout the night) and when their heart bradyed down to 38 for a moment they stated they were just "a little" dizzy. Drew some labs, did some fluid resuscitation and BP was much better afterwards.
Patient came in with hyperkalemia and got a total of 30g kayexalate. 91 year-old. Despite maintenance fluids, I guess pooping up a storm still caused their pressure to drop....
The lowest diastolic pressure I've seen was 7, measured via arterial line transducer.
...iin a severely premature 1-pound neonate in the midst of a bradycardic spell. I think the MAP was 12 - about 1/2 of the bare-minimum-acceptable MAP for him.
Many moons ago in the U.K. we had a girl admitted to resus in a terrible way. I was a young nurse, newly qualified. She had ingested approx 7500mg of Prothiaden/Dothiepin - a tricyclic AD about 10 hrs previously. Her lowest BP reading was 50/10. We really didn't think she'd make it. She did, with no brain or internal organ damage. Left intensive care 5 days later for admission to psych ward. I find myself thinking about her case. The angels (nurses and doctors included) were with her that day.
Do-over, ASN, RN
1,085 Posts
Amazing she had the wind to walk and talk!
Picked up a patient once that had arrested that day (pre-hospital), EF was "
He looked terrible, but was a lovely gentleman, died a couple weeks later. Couldn't believe he even survived the arrest...