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Blood Pressure 01

Blood pressure is measured using a sphygmomanometer and stethoscope. It involves two readings - systolic (highest pressure when heart contracts) and diastolic (lowest pressure when heart relaxes). Normal blood pressure is below 120/80 mmHg. Hypertension is when readings are consistently above 135/90 mmHg. Hypotension is when systolic is below 90 mmHg.

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Fahad Mahmood
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58 views

Blood Pressure 01

Blood pressure is measured using a sphygmomanometer and stethoscope. It involves two readings - systolic (highest pressure when heart contracts) and diastolic (lowest pressure when heart relaxes). Normal blood pressure is below 120/80 mmHg. Hypertension is when readings are consistently above 135/90 mmHg. Hypotension is when systolic is below 90 mmHg.

Uploaded by

Fahad Mahmood
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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BLOOD PRESSURE

Hafiz Ahmad Lubab Khattack

Institute of Nursing,KMU
Blood Pressure

 BLOOD PRESSURE:

Blood pressure (BP) is one of the most important vital signs because
it aids in diagnosis and treatment, especially for cardiovascular health.

 Definition: Blood pressure is the amount of force exerted on the


arterial walls while the heart is pumping blood specifically, when
the ventricles contract.
Blood Pressure

 Blood pressure: is measured by gauging the force of this pressure


through two specific readings: Systolic and Diastolic.

 Systolic blood pressure: is the highest pressure that occurs as the


left ventricle of the heart is contracting.

 Diastolic blood pressure: is the lowest pressure level that occurs


when the heart is relaxed and the ventricle is at rest and refilling
with blood.
Purposes

 To maintain a baseline measure of arterial pressure.

 To assess the hemodynamic (i.e. the study of movement of blood


and the forces concerned) status of a patient.

 To monitor response of the circulatory system to various disease


condition and therapies.
Equipment

 Sphygmomanometer

 B.P cuff

 Stethoscope

 Spirit swab

 Flow sheet

 Black pen
Procedure

1.Identify the patient.

2.Explain procedure to patient.

3.Collect and check equipment.

4.Have patient in sitting or spine position.

5.Wash hands.

6.Clean the ear piece of stethoscope with the spirit swab.

7.Be sure that the manometer is positioned vertically at eye level.

8.Support patient,s fore-arm at heart level, with palm turned up.


Procedure

9.Expose patient,s left upper arm by removing constructing clothing.


10.Wrap the deflated cuff evenly around the upper arm by placing the
lower edge of the cuff 2.5cm (1.2 inch) above the anticubital space.
11.Place of the stethoscope in your ears and check the diaphragm by
tapping.
12.Make sure to unlock the mercury Colum before inflating.
13.Palpate brachial or radial pulse with one hand .Close the valve of
the bulb.Inflat the cuff noting the level of mercury where pulse
disappears.
Procedure

14.Inflate the cuff to 30 mm hg above where the pulse disappeared.

15.Slowly release the valve and allow mercury to fall at the rate of 2-3
mm hg per sec.

16.Note point on manometer when first clear sound is heard.

17. Continue to deflate cuff gradually noting point at which sound


disappear.

18.Asses patient to a comfortable position ,cover the upper arm.

19.Inform client of B.P reading (depend in patient position).


Procedure

20.Clean stethoscope with spirit swab and return equipment to


appropriate place.

21.Wash hands.

22.Record accurately in the flow sheet according to hospital policy.


Pulse Pressure

 Pulse pressure: PP is the difference between the systolic and


diastolic readings and calculated by subtracting the diastolic
reading from the systolic reading. If the blood pressure is 120/80,
the pulse pressure is 40.

 In general, a pulse pressure that is greater than 40 mmHg is


considered widened, and one that is less than 30 mmHg is
considered to be narrowed.
Conti..

 Pulse pressure :

 A widened pulse pressure: may be an indicator for cardiovascular


disease and anemia.

 A narrowed pulse pressure: may be an indicator for congestive


heart failure (CHF), stroke, or shock. Although pulse pressure is
useful in predicting cardiovascular risk in patients.
Blood Pressure Guidelines
Blood Pressure Guidelines
Factors affecting blood pressure

 Race

 Exercise

 Age

 Stress

 Gender

 Medications
Blood Pressure Assessment
Two Methods:
 1. Direct: (invasive, arterial blood pressure monitoring)

 2. Indirect:

I. Auscultatory method

II. Palpatory method


Blood Pressure Assessment

 1.Direct method- A monitor is used for this method. This is a


continuous method which measures mean pressures. A needle
or catheter is inserted into the brachial, radial or femoral artery
and a monitor displays arterial pressure in wave form.

 Direct (invasive) blood pressure monitoring is recommended


in sick and compromised patients, those who are at risk of
developing major blood loss during surgery or for whom
abnormal blood gases are anticipated (patients with respiratory
disease or undergoing thoracotomies).
Blood Pressure Assessment

 2. Indirect method- Taking blood pressure by using


sphygmomanometer.

 Palpatory method:

 In the palpatory method of blood pressure determination,


instead of listening for the blood flow sounds, the nurse uses
light to moderate pressure to palpate the pulsations of the
artery as the pressure in the cuff is released. The pressure is
read from the sphygmomanometer when the first pulsation is
felt.
Conti..

 The Auscultatory method: is most commonly used in


hospitals, clinics, and homes. External pressure is applied to a
superficial artery and the nurse reads the pressure from the
sphygmomanometer while listening with a stethoscope. When
carried out correctly, the auscultatory method is relatively
accurate.
 When taking a blood pressure using a stethoscope, the nurse
identifies phases in the series of sounds called Korotkoff’s
sounds. The systolic pressure is the point where the first
tapping sound is heard while the diastolic pressure is the point
where the sounds become inaudible.
BP Assessment sites:

1. Upper arm

2. Thigh

3. Leg

4. Forearm

Upper arm (using brachial artery (commonest)

Thigh around popliteal artery

Fore -arm using radial artery

Leg using posterior tibial or dorsal pedis


Alteration in Blood Pressure

1.Hypertension

2.Hypotension:

3. Orthostatic Hypotension or Postural Hypotension


Alteration In Blood Pressure

1. Hypertension:

It is an often a symptomatic disorder characterized by persistently


elevated blood pressure. The diagnosis of hypertension is made
when an average of two or more diastolic readings on at least two
visits is 90 mm Hg or higher. Or

when the average of multiple systolic blood pressures on two or


more subsequent visits is consistently higher than 135 mm Hg.
Alteration in Blood Pressure

2. Hypotension: is generally considered present when the systolic


blood pressure falls 90 mm Hg or below.

3. Orthostatic Hypotension or Postural Hypotension:

It occurs, when a normotensive person develops symptoms of and low


blood pressure when rising to an upright position. Or change his
position from lying to sitting and to standing position.

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