Chapter 10-Blood Pressure

Question 1

Define Blood Pressure.

Answer 1

Pressure of circulating blood against the walls of the arteries

Question 2

A decrease in blood presssure may indicate one of the following:

Answer 2

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

Question 3

When any of these conditions occur, how does the body compensate

Answer 3

Increased heart rate
Constriction of the arteries

Question 4

This decreases the blood flow to the ____ and ______ and temporarily redirects the blood volume to _____

Answer 4

skin and extremities

vital organs so they can remain adequately profused

Question 5

However, as shock progresses, the body’s defense mechanism can no longer keep up and eventually what will happen

Answer 5

The blood pressure will fall

Question 6

Decreased blood pressure is a late sign of shock and indicates that that patient is in a critical stage known as ________

Answer 6

Decompensated shock

Question 7

Any patient with low blood pressure has inadequate pressure to maintain

Answer 7

Proper profusion of all vital organs

Question 8

What happens to the arteries as we age?

Answer 8

They progressively get more narrow causing people to have chronically high blood pressure

Question 9

What is an another type of injury that may also cause blood pressure to rise to very high levels?

Answer 9

Head injury

Question 10

Abnormally high blood pressure may result in

Answer 10

A rupture or other critical damage in the arterial system

Question 11

Blood pressure contains two separate key components:

Answer 11

Systolic pressure and Diastolic Pressure

Question 12

What is the increased pressure that is caused along the artery with each contraction of the ventricle and the pulse wave it produces

Answer 12

Systolic Pressure

Question 14

Contraction is another word for

Answer 14

Systole

Question 15

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?

Answer 15

Diastolic pressure

Question 16

The relaxation phase of the hearts cycle is known as

Answer 16

Diastole

Question 17

Systolic pressure represents the ______

Answer 17

Maximum pressure to which the arteries are subjected

Question 18

Diastolic pressure represents _________

Answer 18

The minimum amount of pressure always present in the arteries during

Question 19

Blood pressure is measured in ____

Answer 19

mmHg (millimeters of mercury)

Question 20

Blood pressure is represented as a fraction in the form of

Answer 20

systolic pressure over diastolic pressure

ex: 120/80

Question 22

When should you avoid obtaining a blood pressure reading on a patients arm?

Answer 22

-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)

Question 23

What is the name of the blood pressure reading
cuff?

Answer 23

Sphygommenmeter

Question 24

What are the components of a sphygmomanommeter?

Answer 24

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

Question 25

Most agencies carry at least three sizes of blood pressure cuffs:

Answer 25

Thigh Adult Pediatric

Question 26

A cuff that is too small may result in _____ A cuff that is too large may result in ______

Answer 26

too small- falsely high readings too large- falsely low readings

Question 27

The normal size cuff is designed to wrap around the arm __ to ___ times and take up ____ the length from armpit to elbow

Answer 27

1 to 1.5 times 2/3rds

Question 28

In obese patients, patients with exceptionally well developed muscles, or patients with injury to both arms, use _______

Answer 28

a thigh cuff

Question 29

Measure blood pressure in all patients older than ____ years old

Answer 29

3

Question 30

__________ is the most common means of measuring a patients blood pressure

Answer 30

Auscultation

Question 31

What is the process of auscultation?

Answer 31

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

Question 32

What are these sounds known as?

Answer 32

Kortokoff sounds

Question 33

When are the kortokoff sounds heard?

Answer 33

As cuff is released, blood flow returns to the artery, Kortokoff sounds are heard denoting the systolic pressure

Question 34

The diastolic pressure reading is indicated when kortofoff sounds _______

Answer 34

Disappear

Question 35

It is important to know the patients normal heart rate and blood pressure to use as a ________

Answer 35

Baseline

Question 36

The distal edge of the cuff should be about ___ cm above the crease of the elbow

Answer 36

2.5 cm

Question 37

The center of the cuff usually marked by an arrow should lie directly over the______

Answer 37

brachial artery

Question 38

During the reading, the arm should be held at the same level as the ______

Answer 38

heart

Question 39

Use your ______ hand to palpate the brachial artery and determine where to place the stethoscope

Answer 39

nondominant

Question 40

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

Answer 40

200 mmHg

Question 41

The reading on the gauge when the “taps” or “thumps” of pulse waves can first be heard is known as _______

Answer 41

systolic pressure

Question 42

As pressure in the cuff is progressively reduced and pulse sounds disappear, this is known as _______

Answer 42

Diastolic pressure

Question 43

Blood pressure is often measured by auscultation with the patient in the ______ or _______ position

Answer 43

Sitting or semi-fowler

Question 44

Sometimes when blood pressure is really low, you will hear pulse readings all the way until _____

Answer 44

The gauge reaches 0. In this case, record diastolic pressure as 0.

Question 45

Sometimes, obtaining blood pressure by auscultation may be difficult due to:

Answer 45

Noisy environment Patient movement External vibration from EMS vehicle hypotension poor perfusion uncooperative

Question 46

In an event where you cannot obtain blood pressure by auscultation, obtain blood pressure by ________

Answer 46

Palpation

Question 47

Before performing the palpation (feeling) method, first obtain the patients ______

Answer 47

Baseline

Question 48

What is the first step to obtaining a palpated blood pressure?

Answer 48

Secure appropriate size cuff around the patients arm

Question 49

Then you should:

Answer 49

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

Question 50

Then, slowly inflate the cuff until _____

Answer 50

pulse disappears and continue to inflate to 200mmHg

Question 51

Then release the air from the cuff until

Answer 51

you can begin to feel the radial pulse under your fingertips until reading

Question 52

The reading on this gauge will be the _____ How is it documented

Answer 52

Systolic Pressure 120/P