1. Vital Signs/Blood pressure

2. Blood Pressure Arterial blood pressure is a measure of pressure exerted by the blood as flows through the arteries. (measured by mmHg.) 120/80 mmHg (adults)

3. BP normal limits Two Types of pressure measures: Systolic pressure: as result of ventricles contraction. Diastolic pressure: when the ventricles are at rest. Pulse Pressure: difference between the diastolic and systolic pressures (normal is 40)

4. Determinants of BP Cardiac output Peripheral vascular resistance Blood volume Blood viscosity (Hct. > 60-65%)

5. 5 Factors Affecting BP Age (elasticity of the arteries) Exercise (wait 20-30min) Stress Race : African American males over 35 years have higher BP than European males at the same age. Gender: after puberty, females have lower BP than males due to hormonal variations. Medications Obesity: predispose to hypertension. Diurnal variations: BP lowest early in the morning, then rises during the day Disease process

6. 6 Assessing BP Indirect  Sphygmomanometer and stethoscope  Electronic Sphygmomanometer  Doppler ultrasound Direct (Invasive Monitoring) Arterial lines Sites: Upper arm (brachial artery) Radial ????? Thigh (popliteal artery)

7. 7 Hypertension Cannot be diagnosed unless an elevated blood pressure is found when measured twice at different times. Types: 2. Primary: unknown cause 1. Secondary: known cause Associated factors include: arteriosclerosis, smoking, obesity, alcohol, lack of physical activity, high blood cholesterol and stress. Rx. : treatment of secondary causes, life style changes and monitoring.

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9. 9 Hypotension Is a BP that is below normal, that is systolic between 85 and 110 mmHg in an adult whose normal pressure is higher than this. Orthostatic hypotension: is a BP that falls when the client sits or stands. Causes: drugs, bleeding, severe burn and dehydration Management : supine position 2-3min., V/s, prevent falls, Rx of the cause.

10. 10 Oxygen Saturation Pulse Oximeter: noninvasive device that estimates a client’s arterial blood oxygen saturation (SaO 2 ). Detects hypoxemia before clinical signs and symptoms Normal SaO 2 is 95%-100% SaO 2 below 70% is life threatening.

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