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

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

3. Systolic BP Occurs in the walls of the arteries when the heart contracts. Normal Systolic--- <120 millimeters mercury (mm Hg). Systolic = top # Normal range---90-120 mm Hg

4. Diastolic BP The pressure in the artery walls during cardiac relaxation. Normal diastolic (bottom #)= < 80 mm Hg Normal diastolic range= 60-80 mm Hg

5. Pulse Pressure The difference between systolic and diastolic pressure Normal range is 30-50 mm Hg

6. BP classification 18 y/o & + CategorySystolicDiastolic (mm Hg)(mmHg) Normal<120<80 Prehypertension120-139or 80-89 Stage I hypt140-159or 90-99 Stage II hypt>160or >100

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

8. Factors which Increase BP Excitement Anxiety Stimulant Drugs Exercise Smoking Pain

9. 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.

10. White Coat Hypertension What is this?

11. Factors which decrease BP Rest or Sleep Depressant drugs Shock Fasting

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

13. 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.

14. BP Equipment Stethoscope Sphygmomanometer Alcohol wipes

15. 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

16. 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

17. 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

18. 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.

19. Question: Which arm should be used to measure BP?

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