Lecture 4 - Blood Pressure, Pain Assessment, Nutrition, Violence Flashcards
Describe diastolic and systolic pressure/
Systolic
–> Max pressure on arterial wall during left ventricular contraction (120)
Diastolic
–> Constant pressure blood exerts on arterial walls between contraction (80)
What is Pulse Pressure?
aka Stroke Volume.
Difference between systole and diastolic pressure
What is MAP (Mean Arterial Pressure)?
The pressure propelling blood into tissues averaged over cardiac cycle
Which five factors impact BP?
- Peripheral vascular resistance (vasodilation)
- Cardiac output
- Blood volume
- Blood viscosity
- Elasticity of vessel walls
How does old age affect BP?
Blood pressure rises with age because older adults have less elasticity in BVs. However, if a patient exhibits higher than normal BP, you must assess to determine if it is a pathological issue or normal to aging.
How does sex/hormones affect BP?
Females have lower BP after puberty, and higher BP after menpause
Describe the fluctuation of BP throughout the day
BP is highest first thing in the morning and lowest in the evening
Which medications will increase BP?
Stimulants, nicotine, and some cough and cold medications
Which foods increase BP?
Black licorice, salty + sugary foods, fried foods (related to obesity)
What are the eight steps to taking someone’s BP?
- Correct positioning
- Choose the right cuff (should cover 80-100% of arm length)
- Palpate brachial artery
- Wrap cuff around the arm
- Inflate cuff an additional 30mmHg above where the brachial pulse is extinguished
- Place stethoscope over the brachial artery
- Slowly deflate the cuff
- Note the first sound (systolic) and the last sound (diastolic)
What do you do if one arm has a BP >10mmHg than the other?
Use the arm with the higher BP, as it is a more reliable measurement of circulation in the extremities
What is Orthostatic Hypotension?
Fluctuations (or drops) in blood pressure associated with changes in position or posture?
What BP fluctuations are interpreted as orthostatic hypotentsion?
–> A decrease of systolic pressure less than 20 mmHg
–> A decrease in diastolic pressure less than 10 mmHg
–> An increase in pulse of over 20 bpm
What should you verify is you suspect a patient has orthostatic hypotension?
–> if volume is depleted
–> is the patient has known HTN or any new anti-HTN meds
–> A history of presyncope of syncope
How do you assess for orthostatic hypotension?
Ask patient to remain supine for 2-3 minutes, take baseline HR and BP.
Repeat measurements while sitting and standing.