It is the force of blood against the arterialwalls.
Measure of the lateral pressure exerted by the blood as it flows through the arteries.
Can vary considerably among individuals, so it is important to know a client’s baseline blood pressure.
Auscaltory Gap
Temporary disappearance of sounds normally heard over the brachial artery when the cuff pressure is high and the reappearance of the sounds at a lower level.
Korotkoff Sound
Series of distinct sounds heard through the stethoscope.
Named after a Russian Scientist who first described these sounds
Nikolai Korotkov
2 Blood Pressure Measurements
Systolic Pressure
Diastolic Pressure
2 Blood Pressure Measurements
Systolic Pressure
Highest point of pressure induced by the contraction of the left ventricle.
2 Blood Pressure Measurements
Diastolic Pressure
Lowest point of pressure corresponds to the drop of arterial pressure occuring during the relaxation of the ventricles.
Measured in millimeters of mercury (mmHg) and recorded as a fraction: systolic over diastolic (SYS/DIA).
Typical blood pressure for a healthy adult
120/80 mmHg with 40 mmHg pulse pressure
120 = systolic pressure
80 = diastolic pressure
Factors affecting blood pressure
Age
Rest and Exercise
Stress and Emotional State
Eating
Disease Processes
Obesity
Medications
Race
Environment
Diurnal Variations
Variations in Blood Pressure by Age - Mean Blood Pressure (mmHg)
Newborn: 73/55
1 year: 90/55
6 years: 95/57
10 years: 102/62
14 years: 120/80
Adult: 120/80
Elderly (>70 years): DBP decreases
Equipment for taking Blood Pressure
Sphygmomanometer
Aneroid type
Mercury type
Electronic/Digital type
Equipment for taking Blood Pressure
Sphygmomanometer
Aneroid type
Calibrated dial with a needle that points to the calibrations.
Equipment for taking Blood Pressure
Sphygmomanometer
Mercurytype
Calibrated cylinder filled with mercury.
Pressure is indicated at the point to which the rounder curve of the meniscus rises.
Meniscus → Curve top of a column of liquid in a small tube.
Blood pressure reading should be made with the eye at the level of the rounded curve in order to be accurate.
Equipment for taking Blood Pressure
Sphygmomanometer
Electronic/digital type
Eliminated the need to listen the sounds of the client’s systolic and diastolic blood pressure through a stethoscope.
Automated electronic devices have been shown to give higher values than manual cuffs.
Parts of Aneroid Type
Pump
Valve
Dial
Cuff
Tube
Parts of Aneroid Type
Pump
Inflated the cuff to stop the blood flow in your artery for a few seconds.
Parts of Aneroid Type
Valve
Let some air out of the cuff, which allows the blood flow to start again.
Parts of Aneroid Type
Dial
Numbered dial or a column of mercury can be used to record the blood pressure reading.
Parts of Aneroid Type
Cuff
Wrapped around your upper arm.
Parts of Aneroid Type
Tube
Connects the cuff to the dial.
Blood Pressure Cuff
Consists of a rubber bag that can be inflated with air called the bladder.
Comes in various sizes.
Made of non-distensible material so that an even pressure is exerted around the limb.
Most cuffs are held in place by hooks, snaps, or velcro.
Bladder
Covered with cloth and has two tubes attached to it.
One tube connects to a rubber bulb that inflates the bladder.
One tube is attaches to the sphygmomanometer.
Must be correct in width and length for the client’s arm
Width of the cuff should be 40% of the circumference, or 20% wider than the diameter of the midpoint of the limb.
Gadget that transmits and magnifies the sounds obtain in the body.
In taking blood pressure, the bell or diaphragm of this equipment is placed directly over the brachial artery.
It consists of the earpieces, rubber tubing, and the bell.
Doppler Ultrasound Stethoscope
Used when blood pressure sounds are difficult to hear
Sites of Taking Blood Pressure
Upper arm
Leg
Forearm
Thigh
Sites of Taking Blood Pressure
Upper arm
Where blood pressure is routinely and usually assessed using the brachialartery and a standard stethoscope
Sites of Taking Blood Pressure
Leg and Forearm
in some situations
Sites of Taking Blood Pressure
Thigh
When blood pressure cannot be measured on either arm, or if blood pressure in one thigh is to be compared with the blood pressure in the other thigh.
Methods in Taking Blood Pressure
Indirect or Non-Invasive
Direct or Invasive
Methods in Taking Blood Pressure
Indirect or Non-Invasive
Auscultatory method:
Most commonly used
Uses sphygmomanometer and stethoscope.
Palpatory method:
Used when Korotkoff’s sounds cannot be heard or when auscultatory gap occurs.
Methods in Taking Blood Pressure
Direct or Invasive
An instrument is inserted inside the body invasively to measure the blood pressure via catheter.
5 Phases of Korotkoff's Sounds
Phase 1: pressure level at which the first faint clear tapping sounds are heard, which gradually become more intense.
5 Phases of Korotkoff's Sounds
Phase 2: The period during deflation when the sounds have a swishing quality.
5 Phases of Korotkoff's Sounds
Phase 3: The period during which the sounds are crisper and more intense.
5 Phases of Korotkoff's Sounds
Phase 4: The time when the sounds become muffled and have soft, glowing quality.
5 Phases of Korotkoff's Sounds
Phase 5: The pressure level when the last sound is heard. This is followed by a period of silence.
Assessing Blood Pressure (1-5)
Gather and prepare necessary equipment.
Wash hands.
Introduce yourself and verify the client’s identity.
Explain the purpose and procedure to the client.
Provide for the client’s privacy
Assessing Blood Pressure (6)
Prepare and position the client appropriately.
Adult client should be in sitting position unless otherwise specified. Both feet should be flat on the floor (legs crossed at the knee result in elevated blood pressure).
The elbow should be slightly flexed with the palm of the hand facing up and the forearm supported at heart level.
Expose the upper arm.
Assessing Blood Pressure (7-9)
Wrap the deflated cuff evenly around the upper arm.
If this is the client’s initial examination, perform a preliminary palpatory method of determining systolic pressure.
After obtaining the palpatory systolic pressure, position the stethoscope appropriately.
Assessing Blood Pressure (10)
Auscultate the client’s blood pressure
Inflate the cuff 30 mmHg above the palpatory systolic pressure obtained previously or above the point where the brachial pulse disappeared.
Release the valve at the rate of 2-3 mmHg per second.