Blood Pressure

Question 1

What is the definition of blood pressure?

Answer 1

According to skills for midwifery practice blood pressure is defined as the force that is exerted on the blood vessel walls. It varies within different blood vessels, being highest in the arteries closest to the heart and decreasing gradually within smaller arteries, arterioles and capillaries.

Question 2

What is systolic blood pressure (SBP)?

Answer 2

This is the pressure exerted on the blood vessel walls following ventricular systole when the arteries contain the most blood and is at the time of maximal pressure.

Question 3

What is systolic blood pressure determined by?

Answer 3

1) The stroke volume (amount of blood ejected into the arteries)
2) Force of contraction
3) Distensibility of the arterial wall

Question 4

What is diastolic blood pressure (DBP)?

Answer 4

This is the pressure exerted on the blood vessel walls ventricular diastole when the arteries contain the least amount of blood, resulting in the least pressure.

Question 5

What is diastolic (DBP) influenced by?

Answer 5

1) Degree of peripheral resistance
2) Systolic pressure
3) Cardiac output

Question 6

Why do we measure blood pressure?

Answer 6

It provides valuable information about a woman’s health and enables us as professionals to monitor how her body is responding to pregnancy, labour and birth. It provides a baseline and allows us to monitor her wellbeing and detect any deviations from the norm.

Question 7

What is hypotension?

Answer 7

Low blood pressure-systolic reading of less than 90mmHg

Question 8

What equipment is used to measure blood pressure?

Answer 8

A sphygmomanometer

Pronounced ( sfigg-mom-an-o-meter)

And a stethoscope

Question 9

How is the blood pressure procedure carried out?

Answer 9

According to the NMC Code all women should have access to antenatal care, blood pressure monitoring is a routine process carried out by midwives, before the procedure it is important that in reference to the NMC Code informed consent is given first.

1) Obtain informed consent and explain the procedure
2) Encourage woman to empty her bladder
3) Ensure she is relaxed and both feet are touching the floor
4) Don PPE and wash hands
5) Ensure the correct cuff size is used (using the incorrect size will give an accurate result)
6) Identify brachial artery via palpation (found in the inside of the antecubital fossa)
7) Apply the cuff 2/3cm above the brachial artery
8) Ensure valve is closed, inflate and palpate radial pulse
9) Once the radial pulse can no longer be palpated apply stethoscope to the brachial artery
10) Deflate the cuff slowly until ‘thudding’ is heard
11) The thudding sound is recorded as the systolic pressure
12) When the thudding disappears this is recorded as the diastolic pressure
13) Deflate the remained of the cuff and remove
14) Record findings on Meows Chart
15) Explain the findings to the woman
16) Clean equipment

Question 10

What can high blood pressure indicate?

Answer 10

• Pre-eclampsia
• Emotional state
• Distressed
• Pain
• Medical conditions
• Change in posture
• Recent exercise

Question 11

What does mmHg mean?

Answer 11

Millimetre of mercury

Question 12

What is hypertension?

Answer 12

High blood pressure- above 140/90mmHg

Question 13

What factors can affect accuracy of measuring blood pressure?

Answer 13

• Position (the arm should be at heart level)
• Cuff position (the bladder needs to be positioned over the brachial artery)
• Deflation of the cuff, should be recorded to the nearest 2mmHg
• Equipment should be looked after and maintained
• Ensuring the same operator carries out the procedure to ensure accuracy

Question 14

What can cause high blood pressure?

Answer 14

• Smoking
• Drinking
• Being overweight
• Lack of exercise
• Pain or anxiety