Blood Pressure.pptx

Blood Pressure Vocabulary and Abbreviations  Diastole    High blood pressure Low blood pressure Sphygmomanometer  an instrument for measuring blood pressure mmHg  mmHg stands for millimeters of mercury, and it's a measurement of pressure  Is the measurement for blood pressure HT...

Blood Pressure Vocabulary and Abbreviations  Diastole    High blood pressure Low blood pressure Sphygmomanometer  an instrument for measuring blood pressure mmHg  mmHg stands for millimeters of mercury, and it's a measurement of pressure  Is the measurement for blood pressure HTN    Blood Pressure Orthostatic hypertension   Hypertension BP  Hypotension   The highest amount of pressure during the cardiac cycle (top number)  Hypertension   The lowest amount of pressure during the cardiac cycle (bottom number) Systole   a type of high blood pressure that occurs when someone goes from lying down to standing. Orthostatic hypotension  a drop in blood pressure that occurs when moving from a laying down (supine) position to a standing (upright) position How to take a manual Blood Pressure: Adults  Instruct the patient to sit comfortably with the back and arms supported, feet on the floor, and legs uncrossed  If necessary, remove clothing covering the location of the cuff placement  Measure the patient's blood pressure in the upper arm between the shoulder and the elbow  Ensure that the patient's arm is supported at heart level  Remain quiet during blood pressure measurement and instruct the patient to do the same  Wrap the blood pressure cuff snugly around the patient's upper arm so that the end of the cuff is ¾" to 1¼" (2 to 3 cm) above the elbow crease to allow for placement of your stethoscope. Align the cuff, making sure that the mark on the cuff for the artery is positioned over the artery. The cuff should fit snugly but should still allow for two fingers to slide beneath it  Place the diaphragm or bell of the stethoscope over the patient's brachial artery  Inflate cuff to 160 - 180 mmHg.  When you hear the first beat or tapping sound, that is the systolic pressure  Continue to release air gradually while auscultating for the sound over the patient's brachial artery. Note the pressure where the sound disappears; this is the diastolic blood pressure This image is shows how taking a blood pressure works. Note that the systolic pressure is determined by being able to hear it, and that diastolic is not heard. As explained on the previous slide. Documenting  BP is usually recorded as systolic/diastolic    Example 100/70 Let the provider know if BP is out of parameters i.e. too high or really low  See table on next slide for ranges  If a blood pressure is out of parameters a second blood pressure needs to be taken again after 10 minutes. Make sure to record position and where on the patient the blood pressure was taken. Blood pressure ranges A second blood pressure should be taken 10 minutes after initial check if lower than 90/60 or higher than 140/90. Blood Pressure: Pediatrics  The American Academy of Pediatrics recommends that routine blood pressure measurement begins at age 3 years and continues annually thereafter for otherwise healthy children.  Follow standard procedure for measuring BP.  Below is the normal range for BP per pediatric age group: Age Systolic BP (in Diastolic BP mmHg) (in mmHg) Infant 72-104 Toddler (1-2 years old) 85-113 37-69 Preschooler (3-5 years old) 91-120 46-80 Child (6-12 years old) 96-131 55-62 Adolescent (13-17 years old) 108-143 62-94 Blood Pressure: Pediatrics  High blood pressure in children is a blood pressure that is higher than 95 percent of children who are of the same age, height, and sex as your child.  For toddlers, that tends to be above 98/52 or higher.  For kids ages three to five, that tends to be 100/55 or higher  for kids ages six to twelve, that tends to be 105/66 or higher How to preform an orthostatic blood pressure test  Have the patient lie down for 5 minutes.  Measure blood pressure and pulse rate.  Have the patient stand.  Repeat blood pressure and pulse rate measurements after standing 1 and 3 minutes. NOTE: A drop in BP of ≥20 mm Hg, or in diastolic BP of ≥10 mm Hg, or experiencing lightheadedness or dizziness is considered abnormal. Things to remember  Carefully choose a cuff of the appropriate size for the patient following the manufacturer's instructions for fit and placement  An excessively narrow blood pressure cuff may cause a falsely high blood pressure reading; an excessively wide cuff may cause a falsely low blood pressure reading  Read the dial at eye-level.  Give the patient a 3- to 5-minute rest period without talking or moving before measurement.  Place the cuff on bare skin.  Avoid rolling shirtsleeves to prevent a tourniquet effect.  Avoid rapid deflation, which can cause inaccuracies. (Deflation shouldn't exceed 2 to 3 mm Hg/second.) Things to remember cont.  Ensure that the patient's bladder is empty.   A distended bladder can increase blood pressure Ask the patient not to talk during measurement.  because systolic and diastolic blood pressures increase with talking  Make sure that the environment is quiet.  Instruct the patient to keep the legs uncrossed.  Leg crossing can result in falsely elevated blood pressure measurements  If a patient smoked or had caffeine up to 30 minutes before being seen it can effect blood pressure readings.  The typical site for measuring blood pressure is over the patient's brachial artery  If the patient's upper arms can't be used for blood pressure measurement or if the maximumsize blood pressure cuff doesn't fit the upper arm, blood pressure can be measured in the forearm  If the patient's upper arms or forearms can't be used, measure blood pressure using the thigh or calf  Refer to table on next slide Do not!  Don't measure blood pressure in a patient's extremity with deep vein thrombosis, a graft, or ischemic changes.  Don’t use an affected limb after stroke  Don't apply a blood pressure cuff over a peripherally inserted central catheter or midline catheter; you can apply the cuff distal to the catheter insertion site.  Don't measure blood pressure in a patient's extremity affected by lymphedema after a mastectomy or lumpectomy  Don't take blood pressure on the same arm as an arteriovenous fistula or a hemodialysis shunt Resources   Lippincott Procedures:  Blood pressure measurement, ambulatory care  Blood pressure measurement, pediatric, ambulatory care CDC  https:// www.cdc.gov/steadi/pdf/Measuring_Orthostatic_Blood_Pressure-print.pdf Pediatric Associates  https://pediatricassociates.com/parenting-tips/what-is-the-normal-bloodpressure-for-a-child/