Manual NIBP

Question 1

What is blood pressure?

Answer 1

the outward pressure of blood against blood vessel walls is the product of blood flow from the heart and inward resistance of blood vessel walls

-a variable haemodymamic phenomenon which can vary beat to beat

Question 2

What are some general factors that can effect blood pressure?

Answer 2

-temp
-bladder distension
-pain
-age
-race
-diurnal variation
-gender
-respiration
-emotion
-excersise
-meals
-tobacco
-alcohol
-medications

Question 3

What’s the equation for cardiac ouput?

Answer 3

stroke volume x HR

Question 4

Whats the general equation for NIBP?

Answer 4

cardiac output x total vascular resistance

Question 5

Why must BP measurment be accurate ?

Answer 5

-riskk factor in CHD
-detect silent disease
-determine need for management
-enable appropriate lifestyle advice
-ensure consistency in method for recording
-proffesional responsibility to self and to the patient

Question 6

Name BP equiptment

Answer 6

-Sphyg
-cuff
-stethoscope
-aneroid sphygmomanometer-must be calibrated anually and must register zero when no pressure is applied

Question 7

Describe how to use a stethoscope

Answer 7

-ensure diaphragm is not damaged
-ensure ear pieces are clear and directed into ear canal
-ensure stethoscope is clean and cleaned between patients

Question 8

Describe how to use the cuff

Answer 8

-bladder should cover approx 80% of the arms circumference
-width of cuff should approx cover 40% of arm/ cover 2/3 upper arm from top to bottom
-ensure tubing exits from the top of the cuff

Question 9

What cuff size should you use per arm circumferance?

Answer 9

22-26cm-12x22cm (small adult)

27-34cm-16x34cm(adult)

35-44cm-16x36cm(large adult)

45-52cm-16x42cm (adult thigh)

Question 10

What are the optimum conditions for recording BP?

Answer 10

-relaxed environment
-quiet
-comfortable temp
-preceded by a short period of rest

-Non optimal conditions should be noted

Question 11

Describe the Korotkoff sounds (adults)

Answer 11

K1-sound first appears-sharp thump (SBP)
k2-whoosing sound
K3-crispier and louder sound
K4-a softer blowing sounds that fades
K5-sound finally disappears-(DBP)

Question 12

Describe the first 4 steps of BP procedure

Answer 12

-rest patient for 3-5mins before taking BP
-assess any factors that could influence BP measurement
-provide adequate explanation to patient
-position patient-sitting with feet on the floor and arm supported at the level of the heart

Question 13

Describe the four steps of blood pressure procedure

Answer 13

-remove tight arm clothing
-locate brachial artery in the antecubital fossa
-select appropriate cuff size and apply 2-3cm above the pulse
-support patients arm at the level of the heart , hand, relaxed
-apply pressure 20-30mmHg above pulse
-deflate at 2/3mmHg per s
-record 2 readings 2-3mins apart

Question 14

What should you do if you are measuring someones BP for the first time?

Answer 14

you should record the BP for both arms

Question 15

How do you document BP?

Answer 15

-patients condition and position
-time and date
-record each arm and ensure units are reported
-signature grade

Question 16

What are some general notes for taking BP?

Answer 16

-avoid applying cuff to extremity where IV fluids are infusing
-if patient has had lymphectomy then use other arm
-avoid arms with fistulas (renal)

Question 17

Factors that effect BP

Answer 17

-excersise-increased 02 requirement
-respiratory pump-increased muscle activity
-blood volume
-hormones like ADH
-stroke volume
-diameter of blood vessels
-drugs/alcohol

Question 18

What pressure does the RA have?

Answer 18

Zero- thats why we measure BP at the level of the heart