Chapter 10-Blood Pressure Flashcards
Define Blood Pressure.
Pressure of circulating blood against the walls of the arteries
A decrease in blood presssure may indicate one of the following:
Loss of blood or its fluid components
Loss of vascular tone and sufficient arterial constriction to maintain the necessary pressure even without any actual fluid of blood loss
A cardiac pumping problem
When any of these conditions occur, how does the body compensate
Increased heart rate
Constriction of the arteries
This decreases the blood flow to the ____ and ______ and temporarily redirects the blood volume to _____
skin and extremities
vital organs so they can remain adequately profused
However, as shock progresses, the body’s defense mechanism can no longer keep up and eventually what will happen
The blood pressure will fall
Decreased blood pressure is a late sign of shock and indicates that that patient is in a critical stage known as ________
Decompensated shock
Any patient with low blood pressure has inadequate pressure to maintain
Proper profusion of all vital organs
What happens to the arteries as we age?
They progressively get more narrow causing people to have chronically high blood pressure
What is an another type of injury that may also cause blood pressure to rise to very high levels?
Head injury
Abnormally high blood pressure may result in
A rupture or other critical damage in the arterial system
Blood pressure contains two separate key components:
Systolic pressure and Diastolic Pressure
What is the increased pressure that is caused along the artery with each contraction of the ventricle and the pulse wave it produces
Systolic Pressure
Contraction is another word for
Systole
What is the residual pressure that remains in the arteries during the relaxing phase of the hearts cycle, when the left ventricle is at rest?
Diastolic pressure
The relaxation phase of the hearts cycle is known as
Diastole
Systolic pressure represents the ______
Maximum pressure to which the arteries are subjected
Diastolic pressure represents _________
The minimum amount of pressure always present in the arteries during
Blood pressure is measured in ____
mmHg (millimeters of mercury)
Blood pressure is represented as a fraction in the form of
systolic pressure over diastolic pressure
ex: 120/80
When should you avoid obtaining a blood pressure reading on a patients arm?
-Patient has an intravenous site or other medical device (central lines)-Patient had a mastectomy (breast removal) on that side of
-Patient has an injury to the arm on that side
-Fistula (patients with renal failure or undergoing dialysis)
What is the name of the blood pressure reading
cuff?
Sphygommenmeter
What are the components of a sphygmomanommeter?
A wide cuff
An inflatable wide bladder sewn into a portion of the cuff
A ball-pump with a one way valve that allows air to enter and a turn valve that can be closed, or opened to allow air to be released
A pressure gauge calibrated in millimeters of mercury which indicates the pressure that exists in the cuff that is being applied to the underlying artery
Most agencies carry at least three sizes of blood pressure cuffs:
Thigh
Adult
Pediatric
A cuff that is too small may result in _____
A cuff that is too large may result in ______
too small- falsely high readings
too large- falsely low readings
The normal size cuff is designed to wrap around the arm __ to ___ times and take up ____ the length from armpit to elbow
1 to 1.5 times
2/3rds
In obese patients, patients with exceptionally well developed muscles, or patients with injury to both arms, use _______
a thigh cuff
Measure blood pressure in all patients older than ____ years old
3
__________ is the most common means of measuring a patients blood pressure
Auscultation
What is the process of auscultation?
A blood pressure cuff is applied to the patients upper arm, compressing the brachial artery
The compression creates turbulence and arterial vibrations that make sounds that can be heard with a stethoscope
What are these sounds known as?
Kortokoff sounds
When are the kortokoff sounds heard?
As cuff is released, blood flow returns to the artery, Kortokoff sounds are heard denoting the systolic pressure
The diastolic pressure reading is indicated when kortofoff sounds _______
Disappear
It is important to know the patients normal heart rate and blood pressure to use as a ________
Baseline
The distal edge of the cuff should be about ___ cm above the crease of the elbow
2.5 cm
The center of the cuff usually marked by an arrow should lie directly over the______
brachial artery
During the reading, the arm should be held at the same level as the ______
heart
Use your ______ hand to palpate the brachial artery and determine where to place the stethoscope
nondominant
Continue pumping to increase the cuffs pressure to _____ and then slowly open the valve to allow air to steadily escape until the needle starts dropping
200 mmHg
The reading on the gauge when the “taps” or “thumps” of pulse waves can first be heard is known as _______
systolic pressure
As pressure in the cuff is progressively reduced and pulse sounds disappear, this is known as _______
Diastolic pressure
Blood pressure is often measured by auscultation with the patient in the ______ or _______ position
Sitting or semi-fowler
Sometimes when blood pressure is really low, you will hear pulse readings all the way until _____
The gauge reaches 0. In this case, record diastolic pressure as 0.
Sometimes, obtaining blood pressure by auscultation may be difficult due to:
Noisy environment
Patient movement
External vibration from EMS vehicle
hypotension
poor perfusion
uncooperative
In an event where you cannot obtain blood pressure by auscultation, obtain blood pressure by ________
Palpation
Before performing the palpation (feeling) method, first obtain the patients ______
Baseline
What is the first step to obtaining a palpated blood pressure?
Secure appropriate size cuff around the patients arm
Then you should:
Use your non dominant hand to palpate the patients radial pulse on the same arm as the cuff
Once you locate a pulse don’t move your fingertips until reading is complete
Then, slowly inflate the cuff until _____
pulse disappears and continue to inflate to 200mmHg
Then release the air from the cuff until
you can begin to feel the radial pulse under your fingertips until reading
The reading on this gauge will be the _____
How is it documented
Systolic Pressure
120/P
