Blood Pressure

Question 1

What is systolic pressure?

Answer 1

Blood pressure as a result of contraction of the ventricles - pressure at the height of the blood wave and where pressure is at its greatest (peak).

Question 2

What is diastolic pressure?

Answer 2

Pressure when the ventricles are at rest or filling. Diastolic is the lower pressure, present at all times in the artery.

Question 3

What is pulse pressure?

Answer 3

The difference between systolic and diastolic pressures.

Question 4

What units is blood pressure measured in and how is it recorded?

Answer 4

mmHg (millimeters of mercury)
Recorded as a fraction:
Systolic Pres. / Diastolic Pres.

Question 5

What is the average blood pressure of a healthy adult?

Answer 5

120/80 mmHg

Question 6

What equipment is used to measure blood pressure?

Answer 6

1. Blood pressure cuff.

2. Stethoscope.

Question 7

How do you measure blood pressure (10 steps)?

Answer 7

1. Place cuff 1.5-2inches above elbow.
2. Align the ‘artery’ arrow along the inner aspect of the upper arm.
3. Place stethoscope in place (earpieces in your ears).
4. Feel the patient’s pulse while inflating the cuff.
5. Close the valve control knob.
6. Pump up the cuff 30 mmHg higher above the point when the pulse is no longer felt. (Blood flow in artery will be stopped).
7. Place bell of stethoscope over brachial artery.
8. When patient’s pulse is no longer felt, continue inflating cuff until manometer reads approximately 40mmHg higher (so another 10 mmHg).
9. Slowly release the valve using the valve control knob. (it will take time to learn how to control the deflation rate).
10. Listen for Korotkoff sounds. Note the pressure in phase 1 where there is a sharp tapping - systolic. Then note the pressure immediately after the last sound is heard, phase 5 - diastolic.

Question 8

What are the 5 phases of Korotkoff’s sounds?

Answer 8

Phase 1 - first faint, but clear tapping or thumping sounds, systolic pressure
Phase 2 - muffled, muted, whooshing or swirling sound.
Phase 3 - blood flowing freely, crisper, more intense sound (thumping quality but softer than ph1).
Phase 4 - muffled, soft flowing sound
Phase 5 - period of silence, diastolic pressure is when the last sound is heard.

Question 9

What do you do after taking a patient’s blood pressure reading?

Answer 9

Record the results as a fraction:

Systolic/Diastolic

Question 10

What are other methods and sites to measure blood pressure?

Answer 10

Direct - Invasive monitoring
Indirect - 
    a) Auscultatory   
    b) Palpatory
Sites - 
    a) Upper arm (brachial artery) 
    b) Thigh (popliteal artery)

Question 11

What factors affect blood pressure (9)?

Answer 11

Age 
Exercise
Stress
Race 
Gender
Medication
Obesity
Diurnal Variations
Disease

Question 12

What is hypertension?

Answer 12

Hypertension:

Blood pressure that is persistently above normal.

Question 13

What is primary hypertension?

Answer 13

Primary Hypertension:

An elevated blood pressure due to unknown causes.

Question 14

What is secondary hypertension?

Answer 14

Secondary Hypertension:

Elevated blood pressure due to a known cause.

Question 15

What is hypotension?

Answer 15

Hypotension:

Blood pressure below normal.

Question 16

What is orthostatic hypotension?

Answer 16

Orthostatic hypotension:

Blood pressure that falls when a patient stands or sits.

Question 17

What are some common errors when assessing blood pressure?

Answer 17

1. Bladder cuff too narrow
2. Bladder cuff too wide
3. Arm unsupported
4. Deflating cuff too quickly or too slowly
5. Failure to use the same arm consistently
6. Arm about the level of the heart.

Question 18

How should the patient be positioned while taking blood pressure (arm details in another question?

Answer 18

Sitting position
Arm and back are supported
Feet should be resting firmly on the floor
Feet not dangling

Question 19

Should the arm be raised above the heart? If not where?

Answer 19

No, the arm should be roughly at the same height as the heart.

Question 20

What will happen to the pressure readings if the arm is above the heart? and if the arm is too low?

Answer 20

If the arm is held too high, the readings will be artificially lowered.
If the arm is too low, the readings will be artificially raised.

Question 21

After releasing the control valve, what is the pressure where you hear the first pulse?

Answer 21

When you hear the first pulse, the pressure is at the systolic blood pressure.

Question 22

What is the last pressure at which you can still hear the pulse?

Answer 22

Diastolic pressure

Question 23

Should you avoid moving your hands or head of the stethoscope while taking blood pressure readings?

Answer 23

Yes, because moving your hands and head with the stethoscope could produce noise that can obscure the Sounds of Korotkoff.