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BP Med/Transfusion Question

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1 Hi!

Quick question-

Patient had a low H/H of 8/25 and BP 95/38, HR 120s. Per MD orders, I infused 1 unit PRBCs and took vitals like q2h. BP came up nicely 140s/80s- 150s/85and HR 90s. She may or may not have had to go back to the OR to find out why the H/H dropped (I work nights so MD would assess in the morning). Anyway, I gave 80 mg Micardis which she takes normally at home before I left that morning.
My question is, what this the right thing to do or should I have held it, thinking her BP would come back down if she was indeed having a bleed? I don't know, I am just having some anxiety over hoping I did the right thing. My charge nurse said it was fine, but I'm having new grad jitters

Thanks for listening!
That low BP was about 8 hours before the BP meds.... And stabilized almost immediately. Just to clarify!

Comment:
It was safe to give the Micardis to the pt with a BP 150/80 and not actively bleeding.In the future, if you are second guessing yourself, just give the doctor a call.

Comment:
Also, you probably should have checked the am H&H result first just to be certain that the bleeding had stopped . It was a good question.

Comment:
In a patient who might be continuing to bleed I'd be more worried about the 150/85 than the 95/38. It varies depending on the type and source of the bleed, but typically you want the BP normal to low normal rather than high.

Comment:
Yes, absolutely, I rechecked the h/h and it was maybe 8.1/28 ish so, stable, after the 1 unit of blood.
Author: jone  3-06-2015, 19:05   Views: 550   
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