JPINFV Posted April 17, 2009 Share Posted April 17, 2009 I'm sorry but what is a MAP again, is it the difference in the #'s like 160/100; subtract 100 from 160 and it equals 60, or something else. That's pulse pressure. MAP (mean arterial pressure) is either 1/3(pulse pressure)+diastolic pressure or 1/3 systolic plus 2/3 diastolic pressure or (systolic+2*diastolic)/3. All are mathematically equivalent. Personally, I find the last one the easiest to do in my head. Double the diastolic, add the systolic, round to a number divisible by three (remember, a number divisible by three is one where each component adds up to a number divisible by three. For example, 123/3=41. 1+2+3=6. 6 is divisible by 3) and divide by three. MAP should be at least 60. 70-110 is normal. Link to comment Share on other sites More sharing options...
Doczilla Posted April 17, 2009 Share Posted April 17, 2009 I agree with other posts on this. She's mentating fine, so I wouldn't get too worked up to give fluid just because of a number. Her history suggests some relative hypotension, with the recent starting of a CCB (and dizziness is a frequent side effect). Her symptoms may respond favorably to IV fluid. Probably won't hurt, unless her dizziness is the result of a cardiomyopathy, in which case the IV fluid could push her into acute CHF. Pt. states that that is the BP while not on the Medication; and can't some calcium channel blockers lower the potassium level? No. You're thinking of diuretics. I'm sorry but what is a MAP again, is it the difference in the #'s like 160/100; subtract 100 from 160 and it equals 60, or something else. Mean Arterial Pressure = systolic BP + (2 x diastolic BP). Divide the entire result by 3. I don't get too bent out of shape about the use of "within normal limits". Shorthand is commonly used to represent portions of the usual and customary exam. While this book may say one range, and that book might say another, there is no need to split hairs over these numbers. You can write down the exact number if it makes you feel better. Slick lawyers will find a way to make you look like an idiot no matter what you do. If you use "WNL" to describe part of the exam, you'll have to explain what parts of the exam you did. 'zilla Link to comment Share on other sites More sharing options...
emti2008 Posted April 17, 2009 Author Share Posted April 17, 2009 Thanks, We didn't learn about the MAP, but it's something that is good to know. No. You're thinking of diuretics. I know that diuetics can lower it, but I was talking with a friend who is a nurse and she said that the medication Verapamil can have this affect. I looked up Verapamil and it is a Ca. Channel Blocker, and I didn't see anything about it having a Diuretic in it. Either way, I'm not going to fret over it. I do treat the Pt. for the Pt. and not the #'s, I just wanted to know what the standard #'s were. Thanks to all. Link to comment Share on other sites More sharing options...
medic_texas Posted April 17, 2009 Share Posted April 17, 2009 (edited) To lower your potassium your body has to use it or get rid of it some way. I think your nurse friend is confused. It would suck to be 23 and on calcium channel blockers but reading about them might explain some of the effects on her blood pressure. The question you should be asking your patient is "do you normally have low blood pressure?" I see people talking about the MAP but what does the MAP tell us? Hrmm... Edited April 17, 2009 by medic_texas Link to comment Share on other sites More sharing options...
emsboy_2000 Posted April 17, 2009 Share Posted April 17, 2009 (edited) Without getting a source for the study/review article, we may never know. Machine readings (invasive and non-invasive BPs) will give readings in odd numbers. What struck me is that the 'new' numbers are with in the margin of error for manual BPs anyways. Here is the reference to the meta-analysis: Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-1913. Edited April 17, 2009 by emsboy_2000 Link to comment Share on other sites More sharing options...
Doczilla Posted April 17, 2009 Share Posted April 17, 2009 I know that diuetics can lower it, but I was talking with a friend who is a nurse and she said that the medication Verapamil can have this affect. I looked up Verapamil and it is a Ca. Channel Blocker, and I didn't see anything about it having a Diuretic in it. Either way, I'm not going to fret over it. I think your nurse friend is mistaken. I don't recall hypokalemia as a side effect of CCBs, and I couldn't find any reference that mentioned it. Did you find any reference material that said so? 'zilla Link to comment Share on other sites More sharing options...
emti2008 Posted April 18, 2009 Author Share Posted April 18, 2009 I think your nurse friend is mistaken. I don't recall hypokalemia as a side effect of CCBs, and I couldn't find any reference that mentioned it. Did you find any reference material that said so? 'zilla No that's why I was confused about it. She said that Verapamil has a Diuretic in it, but I think she is mistaken as well because I looked it up on multiple wedsites and can not find where it says that it has one in it. The side effects do say that it can cause dizziness, lightheadedness, headache, fatigue, nausea, and of course a decrease in BP. The signs of OD is also dizziness, LOC, irregular HR, and syncope. It also says if one has SOB or peripheral edema to contact Dr. ASAP because it can cause CHF, it also says it can cause liver and kidney damage. I would rather deal with a little HTN than CHF, but both can kill you so.....anyway I researched the medicine and did not see anything about a diuretic. Link to comment Share on other sites More sharing options...
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