Failure to Assess Blood Pressure Prior to Antihypertensive Administration
Penalty
Summary
A deficiency occurred when a nurse failed to assess and document a resident's blood pressure prior to administering an antihypertensive medication, Procardia XL (Nifedipine), as ordered by the physician. The physician's order specified that the medication could be held if blood pressures were persistently 130/80 mmHg, and the facility's policy required medications to be administered as prescribed, including adherence to the five rights of medication administration. Despite these requirements, the resident's electronic medication administration record (eMAR) showed that blood pressure readings were not assessed or documented before administering the medication on multiple dates. Interviews with the LPN and the Director of Nursing confirmed the importance of checking blood pressure prior to administering antihypertensive medications to prevent unnecessary or potentially harmful dosing. The Director of Nursing stated that medications should not be given outside of physician parameters and that nurses are expected to assess blood pressure before administration. The facility's own policy also emphasized the need for medications to be administered in accordance with prescriber orders and good nursing practices.