Blood Pressure Examination

Question 1

What are the main steps in a BP measurement?

Answer 1

Prepare the patient
Hand hygiene
Select cuff
Apply cuff
Systolic pressure estimation
Auscultate
Conclude assessment

Question 2

How do you prepare the patient?

Answer 2

Introduction and consent
Explanation
Position
- Lying/standing
- Upper arm exposed
- Patient comfortable

Question 3

How do you apply the cuff?

Answer 3

Locate and palpate brachial pulse
Align cuff marking 2-3 cm above brachial artery pulsation
Apply cuff at level of heart

Question 4

How do you estimate systolic pressure?

Answer 4

Palpate radial artery
Inflate cuff until pulse disappears
Deflate cuff and wait 30 sec

Question 5

How do you auscultate in a BP exam?

Answer 5

Place bell of stethoscope over brachial pulse and under cuff
Support patient’s arm slightly bent
Inflate cuff to 30 mmHg above palpated reading
Slowly deflate cuff listening to the Korotkoff sounds whilst viewing the sphygmomanometer to determine systolic and diastolic pressures
Deflate the cuff rapidly to 0 after identifying diastolic reading

Question 6

How do you conclude the assessment?

Answer 6

Remove cuff

Close examination

Question 7

Describe the five phases of the Korotkoff sounds

Answer 7

Phase 1 = thud - systolic BP
Phase 2 = blowing
Phase 3 = tapping/soft thud
Phase 4 = disappearing blowing
Phase 5 = nothing - diastolic BP