Wednesday, September 30, 2009

Learn The Procedure On How To Take Blood Pressure

I want to share again another nursing procedure that you might be interested to learn.  This is the manual type of taking blood pressure of a person using the sphegmomanometer, though digital is readily avalaible and easy to use but if you have sphegmomanometer at home might as well learn how to use it.  Besides that, it is best to monitor the changes of our  blood pressure especially if we have member/s of the family who is suffering the said illness to undertake necessary measures.  This will also benefit the nursing students who are looking for the the right procedure.

Blood pressure (BP) is the pressure (force per unit area) exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs. The pressure of the circulating blood decreases as it moves away from the heart through arteries and capillaries, and toward the heart through veins. When unqualified, the term blood pressure usually refers to brachial arterial pressure: that is, in the major blood vessel of the upper left or right arm that takes blood away from the heart. Blood pressure may, however, sometimes be measured at other sites in the body, for instance at the ankle.

One measure records the pressure while the heart is in systole (when the heart is ejecting blood into the arteries);this is the higher systolic pressure.  The other measure records the pressure while the heart is in diastrole (when the aortic and pulmonary valves are closed and the heart is relaxed);this is the lower or diastolic pressure.  The range of normal blood pressure recording varies according to age and body size but in the normal young adult is approximately 100-120/70-80 mm Hg. 

Why we should perform the procedure?
  1. To provide baseline data 
  2. To monitor changes in blood pressure
Procedure
Assessment:
  1. Assess client’s general condition.
  • Client rest on the bed.
  • Avoid strenuous activity.
  • To select appropriate cuff size.
     2.  To select appropriate cuff size.

Planning:
  1. Prepare the requirements (in a tray)
  • Sphygmomanometer
  • Stethoscope.
  • Alcohol swab in gallipot (to clean stethoscope)
  • Receiver
  • Observation chart
  • Pen (black and red)
  • Ruler
     2. Prepare adequate working space.

Implementation:
  1.  Greet and inform client about the procedure.
  2. Perform hand wash (Prevents cross infection)
  3. Provide privacy
  4. To obtain accurate reading,  position the sphygmomanometer at heart level and ensure the mercury level at zero.
  5. Expose the arm above the placement of cuff. 
  6. Apply cuff 2.5cm above antecubital fossa.
  7. Fold client’s sleeve above the placement of cuff.
  8. Apply the cuff smoothly and firmly with the middle of the rubber bladder directly over the artery. (Too tight cuff will impede circulation whereas too loose will lead to false elevation of pressure.)
  9. Secure the cuff by fixing the Velcro fastener. (Prevent unwrapping of cuff)
  10. Close the valve of the inflation bulb.
  11. Palpate the radial pulse.
  12. Inflate the cuff until pulse is not palpable. (To estimate how high to pump the mercury)
  13. Note the point which pulse disappears. (first reading)
  14. Deflate the cuff slowly.
  15. Palpate brachial artery and place the diaphragm lightly over the brachial artery.
  16. Inflate the cuff further to 20mmHg.
  17. Release the valve slowly.
  18. First audible sound heard is systolic pressure. (First sound heard when the blood begins to flow through brachial artery)
  19. Continue to deflate the cuff. The last sound heard is the diastolic pressure.
  20. Deflate the cuff completely
  21. Remove the cuff from client's arm.
  22. Ensure client is in comfortable. (Advice client to rest if finding show high blood pressure)
  23. Clean the stethoscope with alcohol swab
  24. Tidy up unit
  25. Document the reading in observation chart.

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