Examination: Blood Pressure

Question 1

What is BP?

Answer 1

Pressure of blood in the arteries as it is pumped around the body by the heart.

Question 2

What influences BP?

Answer 2

Age, Exercise, anxiety, coffee, medications etc.

Question 3

How is BP measured?

Answer 3

With a sphygmomanometer.

Question 4

(BP) Step 1:

Answer 4

Prepare the Patient:

• introduction
• confidentiality
• explain the process
• setting
• uncovered upper arm

Question 5

(BP) Step 2:

Answer 5

Hand Hygeine

Question 6

(BP) Step 3:

Answer 6

Select the appropriate cuff:

• Bladder length needs to be ~80% of the circumference of the arm and the width ~40%.
• If too small –> BP will be artificially high

Question 7

(BP) Step 4:

Answer 7

Apply the cuff:

• Feel for the brachial pulse (medial aspect of the antecubital fossa)
• Wrap the cuff on the medial side of the arm with the arrow pointing to the brachial artery.
• Use a pillow to ensure the cuff is at the level of the heart.

Question 8

(BP) Step 5:

Answer 8

Estimate SBP with palpation:

• feel for radial pulse and inflate cuff until that pulse dissapears
• release the cuff completely and wait 30 seconds

Question 9

(BP) Step 6:

Answer 9

Listen to brachial pulse:

- Place diaphragm over brachial pulse and inflate the cuff to just above the SBP reading you got earlier

Question 10

(BP) Step 7:

Answer 10

Listen:

- Slowly deflate the cuff watching the pressure and listen for the auscultatory sounds.

Question 11

(BP) Step 8:

Answer 11

Record the result and thank the patient

Question 12

What is important to tell a new patient?

Answer 12

• You will feel pressure as the cuff inflates, let me know if you’re uncomfortable.