Blood Pressure Flashcards by Katelyn Odom

Measurement of force exerted by the blood on the walls of the arteries

Blood pressure

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Phase in the cardiac cycle in which the ventricles contract. Blood is pushed out of the heart and into aorta and pulmonary artery, exerting pressure on their walls.

Systole

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Point of highest pressure on arterial walls. Recorded during systole

Systolic pressure

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Phase in cardiac cycle in which the heart relaxes between contractions

Diastole

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Point of lesser pressure on arterial walls. Recorded during diastole. Pressure is lower because heart is relaxed.

Diastolic pressure

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Blood pressure is measured and expressed as a fraction what is the numerator? Denominator?

Numerator: systolic pressure
Denominator: Diastolic pressure

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What is BP measured in?

millimeters of mercury (mm Hg)

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Normal BP is what?

Less than 120/80 mm Hg

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What is the BP for prehypertension both systolic and diastolic?

Systolic: 120 to 139 mm Hg
Diastolic: 80 to 89 mm Hg

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BP should be taken at every office visit. Several readings taken on different occasions provide a good index of what?

baseline BP

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Rise or fall of how many mm Hg in baseline BP is significant even if it is still in normal range?

20-30 mm Hg

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High blood pressure

Hypertension

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What is the sustained systolic and diastolic pressure for Hypertension stage 1?

Systolic: 140 to 159 mm Hg
Diastolic: 90 to 99 mm Hg

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What is the systolic and diastolic pressure for Hypertension stage 2

Systolic: 160 or higher mm Hg
Diastolic: 100 mm Hg or higher

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What is caused by excessive pressure on arterial walls and is the most common condition that causes an abnormal BP reading?

Hypertension

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Low blood pressure. Reduced pressure in arterial walls. What is this? What is the BP reading that shows if a person has this?

Hypotension
- BP reading below 95/60 mm Hg

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Difference between systolic and diastolic pressures. Determined by subtracting smaller number from lage number. Example: If BP is 110/70 mm Hg, pulse this would be 40 (110 to 70 mm Hg)

Pulse pressure

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What is the normal range for pulse pressure?

30-50

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What factors increases BP?

Age
Menopause for women
Emotional states (calm patient before taking BP)
Exercise (temporarily increases BP)

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After puberty do women or men have a lower BP (of the same age)?

women

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BP is lower in the morning and higher in the afternoon with this. What is this?
During sleep, there is decreased metabolism and physical activity.
- As metabolism and activity increase during the day what happens to BP?

Diurnal variations
- it rises

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If a patient has been involved in physical activity, allow patient to rest for how long before taking BP?

20-30 mins

BP can vary based on what?
- Diastolic pressure in sitting position s higher or lower than in lying position?
- Do you make a notation if the position is other than siting? What does L stand for? What about St?

Body position
- higher
- Yes!
- L : lying
- St: standing

What may increase or decrease BP?
It is important to record what two types of meds in patient’s chart?

Medications
- prescription and over-the-counter meds

Recent meals, caffeine, smoking, bladder distention, and pain can do what to BP?

Increase BP

What are the two forms of equipment needed for assessment of manual BP?

Stethoscope and Sphygmomanometer

Instrument for amplifying and hearing sounds produced by the body.

Stethescope

What four parts does the stethoscope consist of?

- Earpieces - Sidepieces (binaural) - Plastic or rubber tubing - Chest piece

Large flat disc. Most useful for hearing high-pitched sounds--lung sounds; bowel sounds

Diaphragm

Bowl-shaped appearance. Most useful for hearing low-pitched sounds--hear sounds; vascular system sounds

Bell

Instrument for measuring arterial blood pressure.

Sphygmomanometer

Scale for registering the pressure of air in the bladder

Manometer

The inner inflatable bladder (also part of sphygmomanometer) surrounded by a covering also known as what?

cuff

Part of Sphygmomanometer. This supplied with control valve inflates and deflates the inner bladder

Pressure bulb

Gauge with round scale calibrated in millimeters. Needle points to calibrations. Needle must be at zero before taking BP. What is this?

Aneroid Sphygmomanometer

MA should be no farther than how many feet from the scale of the manometer to ensure accurate reading?

3 feet

Make sure to position manometer for direct viewing when using aneroid sphygmomanometer. When should you recalibrate manometer to ensure accuracy?

every year

Cuff sizes are measured in what?

centimeters (cm)

Refers to inner bladder rather than outer covering

Size of cuff

Inner bladder of cuff should encircle what percentage of arm circumference and no more than what percentage? The inner bladder should be wide enough to cover how much of the distance from the axilla to antecubital space?

- 80% (no more than 100%) - two-thirds

Often used for adult with thin arms

Child cuff

Used for average-sized adult arm

Adult cuff

Used for thigh or adults with large arms

Thigh cuff

If cuff is too small, reading is falsely low or high? If cuff is too large, reading is falsely low or high? - Center of inflatable bag should be directly over what artery? - What is used to secure the cuff?

- High - Low - Brachial artery - Velcro

Centering the inflatable bad directly over the brachial artery allow for what?

Allows for complete compression of the brachial artery

Obese patients with an arm circumference of more than 50 cm (20 inches) may not be posible to fit adult thigh cuff around arm. Blood pressure can be measured using what?

Forearm and brachial artery -Position appropriate-sized cuff midway between elbow and wrist—center of bladder positioned over radial pulse; place the diaphragm over radial pulse; measure blood pressure using the same technique as with the brachial artery

Used to determine systolic and diastolic BP readings. When bladder of the cuff is inflated, brachial artery is compressed and no audible sound is heard. As cuff is deflated, sounds become audible, when blood flows freely, sounds can no longer be heard.

Korotkoff Sounds

Used in some medical offices to measure BP. Used in home monitoring by patients with high BP. Important to use a device that has undergone clinical validation process. Uses an electronic sensor.

Automatic Method

The automatic method measurues what from the wall of the brachial artery as cuff deflates?

Oscillations

Back and forth movement that occurs in the brachial artery as pulse wave travels through it

Oscillations

Point of maximum oscillation corresponds to mean arterial pressure. Computer in device uses this information to calculate systolic and diastolic BP. Results are displayed on screen. What is this? How long does it take approximately? - Mean arterial pressure is also known as...?

Electronic sensor - 30 sec - Overall index of BP

Advantages of Automatic Method:

- Automatically determines how much the cuff should be inflated - To reach a pressure that is 30 mm Hg above systolic pressure - Cuff does not have to be manually inflated and deflated - Performed automatically by the device - Brachial artery does not need to be located - Bladder of cuff does not need to be centered over brachial artery - Stethoscope and user listening skills not required - Electronic sensor measures oscillations from wall of brachial artery to obtain reading - Less susceptible to external environmental noise than manual devices - BP measurement is easy to read - Readings are shown on a digital display screen - Allows for multiple BP measurements - Most come with internal memory - Stores multiple BP measurement

Disadvantages of Automatic Method:

Certain factors can cause the device to fail to obtain a reading - Patient movement - Muscle tremors - Preeclampsia - Dysrhythmias - Very weak pulse—if present, use an alternative method of BP measurement - Because device relies on brachial artery oscillations to obtain a reading: - Stiff arteries (e.g., older patients) can interfere with an accurate reading - Expensive

Prevention of Errors in BP Measurement: - Instruct patient to not consume caffeine, use tobacco, or exercise how many mins before BP measurement? - Patient should be comfortably seated. - Always use proper cuff size - Never take blood pressure over clothing - Position the patient properly - Avoid extraneous sounds from cuff - Compress brachial artery completely - Apply equal pressure over brachial artery - Instruct patient to relax as much as possible and not to talk during procedure - Avoid extraneous sounds from tubing - Position chest piece properly - Rapidly inflate cuff - Release pressure at moderate steady rate - Avoid venous congestion - Measure/document BP in BOTH arms during initial BP assessment of a NEW patient

- 30 mins