Blood Pressure: A good thing to have Health Science CScroggins, MSN, RN

Remembering the Physiology Blood pressure--- force of the blood pushing against the walls of the blood vessels. Types of BP measurements: Systolic Diastolic

Systolic BP Occurs in the walls of the arteries when the heart contracts. Normal Systolic--- <120 millimeters mercury (mm Hg). Systolic = top # Normal range mm Hg

Diastolic BP The pressure in the artery walls during cardiac relaxation. Normal diastolic (bottom #)= < 80 mm Hg Normal diastolic range= mm Hg

Pulse Pressure The difference between systolic and diastolic pressure Normal range is mm Hg

BP classification 18 y/o & + CategorySystolicDiastolic (mm Hg)(mmHg) Normal<120<80 Prehypertension or Stage I hypt or Stage II hypt>160or >100

Factors impacting BP Arterial System— Volume of blood in arteries Hemorrhage Fluid Retention Elasticity of the arteries Vascular resistance

Factors which Increase BP Excitement Anxiety Stimulant Drugs Exercise Smoking Pain

Hypertension=high BP Common Causes: stress, anxiety, obesity, high salt intake, aging, kidney disease, thyroid deficiency, vascular conditions. If untreated---can lead to stroke, kidney disease &/or heart disease.

White Coat Hypertension What is this?

Factors which decrease BP Rest or Sleep Depressant drugs Shock Fasting

Hypotension=low BP May occur with: heart failure dehydration depression, severe burns hemorrhage & shock

Orthostatic Hypotension Sudden drop in both systolic & diastolic Occurs when a pt. moves from a lying to a sitting or standing position. Cause: inability of blood vessels to compensate quickly to position change.

BP Equipment Stethoscope Sphygmomanometer Alcohol wipes

Common BP errors Taking BP when pt. is anxious, angry, or has just been active Inaccurate cuff size Cuff wrapped too loosely=false high reading Too narrow=false high reading Too wide=false low reading

Correct sizing of BP cuff Width of Cuff: approx. 40% of upper arm circumference (distance around) Length of Bladder: approx. 80% of upper arm circumference

Additional BP errors Inflating cuff too high causes pain Too rapid cuff deflation Incorrect arm position Above heart level=false low reading Below heart level=false high reading Patient supporting own arm=false high reading due to muscle contraction

Assessing BP--Correct Positioning of Patient Arm with cuff---at heart level, with pt. seated or lying down. Free of tight or bulky clothing Bladder center directly over Brachial Artery—1 -1 & half inch above antecubital space.

Question: Which arm should be used to measure BP?

Answer In absence of disease=use either arm If pt. has a mastectomy---use the other arm May also depend on IVs, casts