Blood Pressure and Pain Assessment PDF

 B.P. Blood pressure Introduction:- The heart generates pressure during the cardiac cycle to perfuse the organs of the body with blood. Blood flows from the heart to the arteries , into the capillaries and veins, and then back to the...

 B.P. Blood pressure Introduction:- The heart generates pressure during the cardiac cycle to perfuse the organs of the body with blood. Blood flows from the heart to the arteries , into the capillaries and veins, and then back to the heart.  B.P. The heart and circulatory system https://www.youtube.com/watch?v=CWFyxn0qDEU  B.P. Definition Blood Pressure :- It’s the force that blood exerts against the wall of blood vessels resulting from contracting of Lt. ventricle Blood vessel  B.P. Physiology of Blood Pressure:- Duringventricle contraction the maximum pressure exerted against the arterial walls is called “systolic B.P.” When the ventricle relaxation the minimum pressure exerted against the arterial walls it is called “diastolic B.P.”  B.P. - Blood pressure is expressed as the reflection of two numbers; systolic blood pressure and diastolic blood pressure. - Systolic Blood Pressure is the highest blood pressure on the arteries during systole; the phase of the heartbeat when the right and left ventricles contract. Systole causes the ejection of blood out of the ventricles into the aorta and pulmonary arteries. - Normally the value of Systolic Blood Pressure is less than 120 mmHg  B.P. - Diastolic blood pressure is the pressure when the ventricles are at rest during diastole; the phase between each contraction of the heart when the ventricles are filling with blood. It is the lowest pressure, present at all times within the arteries. - Normally Diastolic blood pressure is less than 80 mmHg. - The standard unit for measuring blood pressure is millimeters of mercury (mmHg). - According to the American Heart Association an adult blood pressure is normally less than 120/80 mmHg. Pulse Pressure The difference between systolic and diastolic pressure The top number minus the bottom number is the pulse pressure. So if the resting blood pressure is 120/80 mm Hg, the pulse pressure is 40. This is considered a healthy pulse pressure. Generally, a pulse pressure greater than 40 mm Hg is unhealthy.  Factors affecting blood pressure; A physiological background Five factors influence blood pressure which are: 1.Cardiac output 2.Peripheral vascular resistance 3.Volume of circulating blood 4.Viscosity of blood 5.Elasticity of vessel walls - Blood pressure increases with increased cardiac output, peripheral vascular resistance, volume of blood, viscosity of blood, and rigidity of vessel walls. - Blood pressure decreases with decreased cardiac output, peripheral vascular resistance, volume of blood, viscosity of blood, and elasticity of vessel walls. 1-Cardiac output: is the volume of blood flow from the heart through the ventricles, and is usually measured in litres per minute (L/min). Cardiac output can be calculated by the stroke volume multiplied by the heart rate. Cardiac out put:- Is the amount of blood which bumped from the heart /min. Stroke Volume :- Is the amount of blood pumped from each ventricle with each heart beat  CO = SV x HR Stroke Volume(S) multiplied by Heart Rate (H) Example CO = 70 mL per beat x 70 beats per minute, or CO = 4900 mL/minute.  2-Peripheral vascular resistance: Normally an artery or vein has a compliance to expand to accommodate surges in blood flow without increased resistance or blood pressure. Veins are more compliant than arteries and can expand to hold more blood. as vascular disease causes stiffening of arteries (e.g., atherosclerosis or arteriosclerosis), compliance is reduced and resistance to blood flow is increased. The result is more turbulence, higher pressure within the vessel, and reduced blood flow. This increases the work of the heart.  3-Blood Volume Most adults have a circulating blood volume of 5000 - 6000 ml．  Normally the blood volume remains constant．  As circulating blood volume increases more pressure is exerted against arterial walls and Bp rises.  4-Blood Viscosity Refers to the blood’s thickness which affects the ease with which blood flows through small vessels and is influenced by the presence of plasma proteins and formed elements in the blood. Blood is viscous and somewhat sticky to the touch. It has a viscosity approximately five times greater than water.  4-Blood Viscosity (Cont) The hematocrit is the percentage of red blood cells in the blood, determines blood viscosity as the hematocrit rises and blood flow slows， arterial blood pressure increases and the heart must contract more forcefully to move the viscous blood through the circulatory system.  5-Elasticity of Vessel Walls  Normally the walls of an artery are elastic and easily distensible．  Arterial distensibility prevents wide fluctuations in blood pressure．  With a reduced elasticity there is greater resistance to blood flow，and the systemic pressure rises．  Systolic pressure is more significantly elevated than diastolic pressure as a result of reduced arterial elasticity．  B.P. Factors affecting blood Pressure:- ( A ) which increase the B.P. :- 1. Age ---------> B.P ↑ with age old age due to ↓ elasticity of blood vessels. ↑ sympathetic Activity as in Anxiety, pain ,stress, Exercises --> ↑ H.B. -----> bl. Volume. ↑ B.P. 2. Position. 3. Diet ---------> Salty food, & fatty food. 4. Exercises. 5. Alcohol & smoking 6. Some Diseases e.g. Renal & Cardiac disease 7. Some Drugs e.g. Anti-hypotensive ( Effortel )  B.P. ( B ). Which decrease the B.P.:- 1-Fasting. 2-B.P. lower at night than the day. 3-Is lower in hot weather. 4-Medications e.g. Diuretics, Analgesics, Antihypertensive. 5-Some diseases e.g. Anemia, bleeding & shock.  B.P. A B C  Blood pressure categories According to The American Heart Association blood pressure is categorized as normal, elevated, or stage 1 or stage 2 high blood pressure: - Normal blood pressure is systolic of less than 120 and diastolic of less than 80 (