The Student Nurse's Bible by Peter Conway - HTML preview

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Chapter Four

How to take blood pressure

Ask your patient to sit comfortably and relax.
Wash your hands
Push the patients sleeve up and wrap your deflated pressure cuff around the arm just above the elbow. Centre the cuff bladder over the brachial artery and position the gauge so you can easily read it. Leave enough room to slide two fingers in between the arm and the cuff.
Extend the arm and support it at heart level. Palpate for a brachial pulse over the brachial artery in the crook of the elbow.
Insert the stethoscope earpieces into your ears and place the bell or diaphragm over the place you felt the brachial pulse. Close the bulbs thumbscrew by turning counter clockwise. Listen to the brachial pulse as you pump air into the cuff and rapidly inflate to 10mm/Hg above where you heard the last sound.
Slowly open the thumbscrew on the bulb and allow 5mmHg/sec to drop. Watch the gauge and listen as the cuff deflates. Mentally note the pressure on the gauge when you hear the first sound (this is the systolic pressure)
Continue listening as the cuff deflates and when you can no longer hear the pulse, record this number as the diastolic pressure.
Then rapidly deflate the cuff. Wait one minute if you need to repeat your measurement to confirm.
Write down your findings and wash your hands.
The systolic pressure represents the maximum pressure in the arteries as the heart contracts. The diastolic pressure represents the pressure in the arteries when the heart is at rest.
Optimal blood pressure is considered less than 120systolic and 80 diastolic.

Tips

Never take a blood pressure in an arm with an IV line in place, a dialysis or other fixed tube or on the same side as a mastectomy.
Wait at least one minute between repeating a measurement.

What you need

Stethoscope

 

Sphygmomanometer