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CLINICAL SKILLS III > LECTURE 5 (Blood pressure measurement) > Flashcards

LECTURE 5 (Blood pressure measurement) Flashcards

1
Q

What is Systolic pressure?

A

The peak pressure of the contracting left ventricle causing blood ejection to the aorta

[max pressure during one heartbeat]

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2
Q

What is Diastolic pressure?

A

pressure in your arteries when your heart rests between beats

[aortic pressure is at its lowest]

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3
Q

How do you calculate Blood pressure?

A

BP = CO X SVR

BP = BLOOD PRESSURE
CO = CARDIAC OUTPUT
SVR = SYSTEMIC VASCULAR RESISTANCE

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4
Q

How do you calculate Cardiac output?

A

CO = HR X SV

CO = CARDIAC OUTPUT
HR = HEART RATE
SV = STROKE VOLUME

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5
Q

What is the normal BP?

A

Systolic: 110-130
Diastolic: 70-80

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6
Q

What does Blood pressure depend on?

A
  • Age
  • Activity and sleep (lowest at sleep)
  • Emotion/positioning
  • Physical condition/fitness
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7
Q

What is Hypotension?

A

Systolic blood pressure below 90 mmHg in adults

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8
Q

What are the indications of hypotension?

A
  • Orthostatic hypotension
    [sudden drop in BP when the patient rises from a supine or sitting position]
  • Symptom of shock, haemorrhage and malnutrition
  • Hypoxia
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9
Q

What are the common symptoms of Hypotension?

A
  • Dizziness
  • Fainting
  • Confusion/trouble concentrating
  • Fatigue/weakness
  • Nausea/vomiting
  • Blurred/distorted vision
  • Fast/shallow breathing
  • Agitation/unusual changes in behaviour
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10
Q

What is Hypertension?

A

Blood pressure of 140/90 mmHg or greater

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11
Q

What is the difference between Primary hypertension and Secondary hypertension?

A

Primary hypertension = no single known cause

Secondary hypertension = related to a known factor/disease

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12
Q

What factors lead to hypertension?

A
  • Gender
  • Genetic factors
  • Age
  • Obesity/lack of exercise
  • Smoking/Alcohol intake
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13
Q

What are the complications of uncontrolled hypertension?

A
  • Disrupted blood supply to brain (stroke, dementia)
  • Hearing loss
  • Kidney scarring/failure
  • Vision loss
  • Coronary artery disease
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14
Q

What is Mean Arterial Pressure (MAP)?

A

Calculation of systolic and diastolic blood pressure that indicates the degree of tissue perfusion to vital organs

[should exceed 70 to ensure cerebral tissue perfusion]

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15
Q

What is the equation to calculate MAP?

A

MAP = 1/3 SBP + 2/3 DBP

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16
Q

Which physiological mechanisms control blood pressure?

A
  • Hormonal control
  • Neural control
  • Renal control
  • Skeletal muscle contractions. respiration and patient positioning
17
Q

When should you measure Blood pressure?

A
  • Admission to ward
  • Every 12 hours in hospital
  • Risk/has infection
  • Assess response to interventions to correct patient’s BP
  • Critically/acutely ill patients
  • During/after blood transfusion
  • Signs of shock
  • Patient receiving medications that can alter BP
18
Q

What are the contraindications of Blood pressure?

A
  • Oscillometric blood pressure devices may not be accurate with weak pulse/patients with pre-eclampsia
  • BRACHIAL ARTERY should not be used when: patient with ARTERIOVENOUS FISTULAS, BRACHIAL ARTERY SURGERY or risk of LYMPHOEDEMA
  • Trauma to upper arm, previous mastectomy or forearm aputation
  • Patients with ATRIAL FIBRILLATION should have auscultatory blood pressure measurements
19
Q

Describe direct (Invasive) BP monitoring

A
  • Enables continuous monitoring of BP
  • Commonly used for critically ill patients in ICU
  • Cannula inserted into an artery -> Cannula has transducer attached to a CARDIAC MONITOR (BP shown as a waveform)
  • Attached to a pressurised flush of solution to prevent blood back flow
20
Q

Describe Indirect BP measurement

A

Manual auscultatory sphygmomanometers or automated oscillometric devices

21
Q

What are Korotkoff sounds?

A

“tapping” sounds heard with a stethoscope as the cuff is gradually deflated

22
Q

Which sound phases are defined as systolic and diastolic pressure?

A

SYSTOLIC PRESSURE = K1 (Phase 1)
[tapping sound]

DIASTOLIC PRESSURE = K4 (Phase 4)
[blowing sound]

23
Q

What are the alternative sites for BP measurement?

A
  • Brachial artery
  • Radial artery
  • Popliteal artery
  • Dorsalis pedis artery
24
Q

What is Orthostatic hypotension?

A

A drop in arterial BP of at least 20 mmHg for systolic BP and 10 mmHG for diastolic BP

25
Q

Describe the patient preparation

A
  • Standardised environment (seated)
  • Arm should be outstretched
  • Brachial artery should be at heart level
  • Patient’s back should be supported
26
Q

What are the Post-procedural considerations?

A
  • Immediate care (if high BP - medications, if low BP - fluid replacement therapy)
  • Chronic hypertension -> lifelong drug therapy
  • Determine cause of altered BP
  • Ongoing care (medications, lifestyle advices)
  • Documentation

CLINICAL SKILLS III (13 decks)

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