Pain management in patients with low BP

I am constantly confronted with this situation in the acute care setting: Pain medication is often withheld when an oncology patient’s blood pressure is low. How is this situation best managed? — Jeri L. Ashley, MSN, RN, AOCNS, CHPN

The key to answering this question is to understand there is no single correct answer. Each patient situation must be assessed individually. Considerations to weigh: Is the patient opioid tolerant? Does the decrease in BP correlate with a change in pain medication, or is it independent? What else may be causing the low blood pressure? Is the patient awake and alert, or sedated?

Low blood pressure is not an absolute contraindication to administering pain medication. When in doubt, ask for parameters from the physician who prescribed the pain medication, then monitor, assess, and treat the patient’s pain. — Ann Brady, MSN, RN-BC