once obtained, the breastfeed records it with the systolic reading ( this is the beginning sound listen ) over the diastolic rake coerce understand ( the point when the healthy stops ). For exercise, a blood blackmail read may look something like this : 114/76. The 114 is the systolic reading and the 76 is the diastolic read .
Why does a nurse need to know how to check a manual blood pressure when there are digital devices that will perform this skill?
Digital or automatic pistol devices may not be available at all times. In addition, manual of arms blood pressure measurement devices provide a more accurate blood imperativeness reading than digital ones. According to a survey by Journal of Clinical and Diagnostic Research, an aneroid device ( which is used during a manual blood blackmail measurement ) is more accurate than a digital device [ 1 ] .
therefore, as a nurse you should constantly reassess a leery blood coerce reading with a manual rake imperativeness measurement .
Video on How to Take a Blood Pressure Manually
Steps on How to Take a Blood Pressure Manually
here are the steps to take a manual lineage imperativeness. Note : Before taking a affected role ’ s rake pressure, always verify the specific steps required by your healthcare facility or nursing school, as guidelines or protocols may change over clock .
1. Perform bridge player hygiene and gather your supplies .
- Supplies needed: stethoscope, sphygmomanometer (blood pressure cuff with aneroid manometer gauge), cleaning supplies, towels or pillow for support (if needed)
- Tip: always use an appropriately sized blood pressure cuff
2. Have the patient sitting or lying down with their back supported. Their arm should be positioned at center degree. If necessity, use towels or a pillow to support the weapon, and make sure the palm are facing up ( supinated ). Be sure the peg are besides uncross. For best results, the patient should urinate before the operation, keep off eat or toast anything for 30 minutes before the measurement is taken, and should remain placid [ 2 ] .
- Find the brachial artery near the proximal (top) portion of the elbow’s bend (in the cubital fossa area):
- This is the most common site for checking the blood pressure and is a major artery in the upper arm that divides into the radial and ulnar artery.
- To find this artery, extend the elbow joint and have the palm facing upward. The pulse point is found near the top of the cubital fossa, which is a triangular area that is in front of the elbow.
3. place and secure the blood pressure handcuff on the patient ’ s upper sleeve. home it about 2 inches above the elbow. In accession, make sure the arrow on the blood press cuff is lined up with the brachial artery. In addition, be certain the cuff is secured over the bare skin, and attach the gauge ( aneroid manometer ) so that you can easily read it as you palpate.
4. first, we will estimate the systolic pressure by palpating the brachial artery and inflating the cuff to the point where the pulsate disappears. Turn the bulb ’ s valve clockwise to tighten. Make sure the gauge is at zero, and pump until you no longer feel the brachial artery ’ south pulsate. eminence that act on the gauge when you no longer feel the brachial artery, as this is the estimated systolic pressure. then deflate the cuff by turning the bulb ’ s valve counterclockwise, and wait 30 to 60 seconds.
- Why do we do this? By first estimating the systolic pressure, we can avoid missing the auscultatory gap in certain patients. The auscultatory gap is an abnormal silence during auscultation that can lead the clinician to obtain an inaccurate systolic reading, which is the first sound heard during auscultation. This gap occurs in SOME patients (not all), especially if they have hypertension.
5. Place your stethoscope in your ears, palpate the brachial artery again, and place the bell of the stethoscope lightly on the brachial pulse locate ( you can use the diaphragm quite than the bell if you want, but the bell is the best for hearing depleted pitched sounds ).
6. Verify the gauge is at zero, and inflate the handcuff 30 mmHg above the number at which you felt the brachial artery ’ mho pulsate vanish when estimating the systolic pressure. For exemplar, if the brachial artery ’ mho pulsation disappeared at 100 mmHg, inflate the manacle to 130 mmHg.
7. future, deflate the handcuff slowly by turning the light bulb ’ s valve counterclockwise until the needle drops at a speed of about 2 mmHg per second .
8. Listen carefully for the very inaugural sound to appear, and note the point on the bore when you heard it. This is the systolic blood pressure number ( acme total ) of your blood imperativeness read.
9. Continue to allow the air out to slowly leave the handcuff, and note the item on the estimate when the strait stops completely. This is the diastolic blood pressure number, which is the lower number in a blood pressure read. Note : In the by, the diastolic count may be referred to as the last faint sound hear ( besides known as the Korotkoff phase 4 reasoned ). however, many newer guidelines suggest the diastolic blackmail is the point at which the phone is no long heard ( besides known as Korotkoff phase 5, which is secrecy ) .
The television below demonstrates a blood pressure measurement with audible systolic and diastolic sounds as you watch the gauge :
10. Open the bulb ’ south valve completely by turning it counterclockwise, allowing the manacle to deflate .
11. Remove the cuff from the patient ’ sulfur arm .
12. Clean the manacle and devices used, and perform hand hygiene .
13. Document per your facility ’ s protocols, making sure to include necessary information such as the blood press read, the patient ’ sulfur place ( sitting or lying ), and the arm used to measure the blood imperativeness .
How to Interpret the Blood Pressure Reading
here are the blood atmospheric pressure guidelines published by the American College of Cardiology, final updated in 2017 [ 3 ] :
- A normal blood pressure is a systolic pressure of less than 120 mmHg and a diastolic pressure of less than 80 mmHg.
- An elevated blood pressure occurs when the systolic pressure is between 120-129 mmHg, and the diastolic pressure is less than 80 mmHg.
- Hypertension Stage 1 occurs when the systolic pressure is between 130-139 mmHg, or the diastolic pressure is between 80-89 mmHg.
- Hypertension Stage 2 occurs when the systolic pressure is greater or equal to 140, or the diastolic pressure is greater or equal to 90 mmHg.
For a patient to be diagnosed as having high blood pressure, they need an average reading based on 2 readings or more that are obtained on 2 or more occasions [ 3 ] .
1. Shahbabu, B. ( 2016 ). Which is More Accurate in Measuring the Blood Pressure ? A Digital or an aneroid barometer Sphygmomanometer. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. department of the interior : 10.7860/jcdr/2016/14351.7458
Read more : How To Do a Smokey Eye
2. Centers for Disease Control and Prevention. ( 2021, September 27 ). Measure your blood atmospheric pressure. Centers for Disease Control and Prevention. Retrieved February 16, 2022, from hypertext transfer protocol : //www.cdc.gov/bloodpressure/measure.htm
3. 2017 Guideline for High Blood Pressure in Adults – American College of Cardiology. ( 2018 ). Retrieved from hypertext transfer protocol : //www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/11/09/11/41/2017-guideline-for-high-blood-pressure-in-adults