1. VITAL SIGNS BLOOD PRESSURE PULSE TEMPERATURE RESPIRATIONS

2. WHY MEASURE VITAL SIGNS? REFLECTIVE OF THE HEALTH STATUS OF AN INDIVIDUAL EASILY OBTAINABLE

3. BLOOD PRESSURE 1 in 3 Americans have high blood pressure 31.6% of persons that have high blood pressure are unaware that they have it High blood pressure(hypertension) significantly increases the risk for heart disease and stroke

4. What is Blood Pressure? Blood pressure is the force in the arteries when the heart beats(systolic), and when the heart is at rest(diastolic) Blood pressure is measured in millimeters of mercury(mmHg)

5. HEART FUNCTION IN BP

6. NORMAL BLOOD PRESSURE

7. HYPERTENSION PERSISTENTLY ELEVATED BLOOD PRESSURE – CURRENT STANDARDS > 140/90

8. METHODS FOR OBTAINING A BLOOD PRESSURE DIRECT – Direct intra-arterial measurement with a catheter INDIRECT – Compression of the brachial artery using a sphygmomanometer(blood pressure cuff)

9. INDIRECT METHOD OF OBTAINING A BLOOD PRESSURE Introduced in 1896 by Riva Rocci The method involves occluding the brachial artery and listening for audible sounds These sounds are called “Korotkoff” sounds named after the Russian physician that described them

10. Systolic – Pressure at which the sounds first appear Diastolic – Pressure at which the sounds are no longer audible

11. EQUIPMENT FOR OBTAINING A BLOOD PRESSURE

12. DEVICES FOR OBTAINING A BLOOD PRESSURE

13. STETHOSCOPE

14. PLACEMENT OF EAR PIECES

15. METHOD FOR TAKING A BP

16. SEAT THE PATIENT IN A COMFORTABLE POSITION

17. SELECT THE APPROPRIATE SIZE CUFF Adult – The bladder should encircle 80% of the arm Children – The bladder should encircle 100% of the arm

18. Palpate and locate the brachial artery

19. Position the cuff so the bladder is over the artery and the cuff is 1- 2cm above the antecubital fossa

20. Position the cuff so you can see the manometer

21. Inflate the BP cuff Inflate to 70 mm Hg and increase by 10 mm until the radial pulse disappears Note this level and inflate the cuff 20 - 30 mm Hg more to overcome an ausculatory gap

22. Recording the BP Place the stethoscope over the brachial artery just above the antecubital fossa Inflate the cuff slowly, then release the valve

23. Record the systolic and diastolic readings First sounds heard will be the systolic Continue deflating the cuff until the last sound is heard the diastolic

24. Measurement should be repeated after 30 seconds The blood pressure is the average of the two readings

25. ERRORS IN TAKING BP Cuff too big – BP too high Cuff over clothing – inaccurate reading Stethoscope occluding ear – distorted sound Stethoscope turned incorrectly – no sound

26. PULSE Palpate the radial artery Use the middle and index fingers(NO thumb) Count the pulses for 15, 30 seconds and X Count the pulses for 1 minute

27. RESPIRATIONS Seat the patient in a quiet comfortable environment Count the number of times the chest rises and falls in 30 or 60 seconds Average number of respirations 12 – 20/minute Bradypnea – Slower that 12/minute Tachypnea - Persistent over 20/minute

28. TEMPERATURE

29. ORAL AXILLARY - LOWER RECTAL - HIGHER

30. PRACTICE!!!!