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.

Read more >>

Giving And Removing Bedpan To A Patient

Here we will learn on how to give and remove a bedpan to a patient.  But first we should know what is bedpan, its importance and why do we need the procedure.

What is bedpan?

Bedpan is an object used for the toileting of a bedridden patient in a health care facility, usually made of a metal, glass, or plastic receptacle. A bed pan can be used for both urinary and fecal discharge

Why they are necessary

1. 
   
    Many diseases can confine a patient to bed, necessitating the use of bedpans.
   
   
   
2. 
   
   Additionally, many patients may be confined to a bed temporarily as a result of a temporary illness, injury, or surgery, thereby necessitating the use of a bed pan.
   
   
   

 Procedure of giving and removing bedpan to a patient.

1.  Wear disposable glove.
2. If the bedpan is metal, warm it by rinsing it with warm water.
3. 
   
   Adjust the bed to a height appropriate to prevent back strain.
   
   
   
4. 
   
   Elevate the side rail on the opposite side to prevent the client from falling out of bed.
   
   
   
5. 
   
   Ask the client to assist by flexing the knees, resting the weight on the back heels, and raising the buttocks, or by using a trapeze bar, if present.
   
   
   
6. 
   
   Help lift the client as needed by placing one hand under the lower back, resting your elbow on the mattress, and using your forearm as a lever.
   
   
   
7. 
   
   Lubricate the back of the bedpan with a small amount of hand lotion or liquid soap to reduce tissue friction and shearing.
   
   
   
8. 
   
   Place a regular bedpan so that the client’s rest on the smooth, rounded rim. place a slipper pan with the flat, low end under the client’s buttocks.
   
   
   
9. 
   
   For the client who cannot assist , obtain the assistance of another nurse to help lift the client onto the bedpan or place the clients on his or her side , place the bedpan against the buttocks and roll the clients onto the bedpan.
   
   
   
10. 
    
    To provide a more normal position for the clients lower back elevates the client’s bed to a semi Fowler’s position. If permitted. If elevation is contraindicated, support the clients back with pillow as needed to prevent hyperextension of the back.
    
    
    
11. 
    
    Cover the clients with bed linen to maintain comfort and dignity.
    
    
    
12. 
    
    Provide toilet tissue, place the call light within reach, lower the bed to the low position, elevate the side rail if indicated and leave the client alone.
    
    
    
13. 
    
    Answer the call bell promptly
    
    
    
14. 
    
    Do not leave anyone on a bedpan longer than 15 minutes unless they are able to remove the pan themselves. Lengthy stays on a bedpan can causes pressure ulcer.
    
    
    
15. 
    
    When removing the bedpan, return the bed to the position used when giving the bedpan, hold the bedpan steady to prevent spillage of its content, cover the bedpan, and place it on the adjacent chair.
    
    
    
16. 
    
    If the client needs assistance, don glove and wipe the patient’s perineal area with several layers of toilet tissue. If a specimen proof is needed place the tissue in a receptacle other than the bedpan.
    
    
    
17. 
    
    Wash the perineal area of dependent patient with soap and water and thoroughly dry the area.
    
    
    
18. 
    
    For all patients, offer warm water soap, a washcloth. and a towel to wash the hands.
    
    
    
19. 
    
    Assist the pateints to a comfortable position, empty and clean the bedpan, and return it to the bedside.
    
    
    
20. 
    
    Remove and discard you gloves and wash your hands.
    
    
    
21. 
    
    Spray the room with air freshener as needed to control odor unless contraindicated because of respiratory problems or allergies.
    
    
    
22. 
    
    Document colour, odour amount and consistency of urine and feces and the condition of the perineal area
    
    
    

Read more >>

Vacine Recommendations For A(H1N1)

When the vaccine for influenza A(H1N1) becomes available, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommends that the following groups be vaccinated:

• pregnant women
• people who live with or care for children less than 6 months old
• health care and emergency services personnel
• people between the ages of 6 months through 24 years of age
• people ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems

In the event of a vaccine shortage, the ACIP recommends that the following groups receive the vaccine before others:

• pregnant women
• people who live with or care for children less than 6 months of age
• health care and emergency services personnel with direct patient contact
• children between 6 months and 4 years of age
• children ages 5 through 18 years of age who have chronic medical conditions

To decrease the incidence of secondary pneumococcal pneumonia, the CDC is also recommending prophylactic administration of 23-valent pneumococcal polysaccharide vaccine (PPSV23) during the outbreak of novel influenza A(H1N1). The recommendations of the CDC's Advisory Committee on Immunization Practices (ACIP) are as follows:

• Vaccination for all persons over 65 years of age
• Vaccination for persons 2 to 64 years with the following medical conditions:
  
  
  • Chronic cardiovascular disease (congestive heart failure and cardiomyopathies)
  • Chronic pulmonary disease, including COPD and emphysema
  • Diabetes mellitus
  • Alcoholism
  • Chronic liver disease, including cirrhosis
  • Cerebrospinal fluid leaks
  • Functional or anatomical asplenia, including sickle cell disease and splenectomy
  • Immunocompromised conditions, including HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome; those receiving immunosuppressive chemotherapy (including corticosteroids); and those who have received an organ or bone marrow transplant
  
  
  
  
• Vaccinations for persons 19 to 64 years who have asthma or smoke.

*Note: A single revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65 years as well as for people at highest risk, such as those who have no spleen, and those who have HIV infection, AIDS or malignancy.

Read more >>