During observational rounds on my first week of placement, I encountered an obese elderly man with type 2 diabetes who was bed bound. His BP was 98/73 so I decided to do a manual blood pressure (BP) to make sure it was not a mechanical error from the automatic machine and recorded 99/75. His other vital signs were in between the flags. I asked my patient how he was feeling, he said he felt fine. I told him his blood pressure was a bit low and if this was normal for him. He said it has been low a bit recently. I asked him if he could have a glass of water and explained how this can help in elevating his BP so he had a glass and a half of water. I also made sure he was lying flat on his back as this can give a false reading. I checked his file for any altered calling criteria but there was none. I went to consult with my registered nurse and she suggested I speak with his medical officer (MO) about this patient and inform her of my observations and see if she was happy with this reading. He had recently changed medications for his heart rate and cholesterol which could have influenced his low blood pressure reading. The MO suggested I take his blood pressure again in 15 minute and at 30 minutes to see if there was any change and to report back to her of my results. I recorded no significant change but his systolic did read above 100 and the patient remained asystematic so the MO was happy with the result but remained aware of the situation. I felt concerned for my patient during this entire incident as he was almost in the red zone which would have been a met call and I have never been in a situation where this has happened. Once I considered the patients situation I began to see a picture of his life and how all of his comorbidities were connected. Being aware of how medications can alter a person’s blood pressure and looking them up in the MIMS help better my understanding of why my patient was experiencing a drop in blood pressure.
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