Physical Examination (Blood Pressure)

Question 1

Patient Preparation for BP (8)

Answer 1

1. No smoking, caffeine, or activity 30 minutes prior 2. Resting 5-10 minutes 3. Back supported 4. Feet flat on ground 5. Quite and warm room 6. Arm rested with no clothing 7. Arm at heart level 8. Arm supported

Question 2

Arm Height Influences on BP

Answer 2

• Above heart (low BP reading) - Below heart (high BP reading)

Question 3

Applying BP Cuff (4)

Answer 3

1. Place bottom 1’’ from crease in cubital fossa 2. Arrow should point towards brachial artery 3. Apply to bare skin 4. Be sure cuff is correct size

Question 4

Estimating Systolic BP

Answer 4

• Palpate radial artery and then pump the cuff until the pulse is no longer palpable - Inflate cuff 30n mm/Hg greater than estimated systolic BP

Question 5

BP Cuff Deflation

Answer 5

• Release cuff about 3-5 mm/Hg per second

Question 6

Falsely Raised BP (11)

Answer 6

1. Loose or too small cuff 2. Bladder that balloons outside of cuff 3. Smoking 4. Caffeine 5. Being cold 6. Atherosclerosis 7. White coat hypertension 8. Circadian variations 9. Physical activity 30 minutes prior 10. Brachial artery lower than heart 11. Repeated inflation of cuff

Question 7

Falsely Lowered BP (3)

Answer 7

1. Brachial artery above heart 2. Too large of a cuff 3. Circadian variation

Question 8

Common BP Measuring Errors (4)

Answer 8

1. Arm below heart 2. Loose cuff 3. Cuff too small 4. Cuff too large

Question 9

What side of the stethoscope should BP be taken with?

Answer 9

• Bell side

Question 10

Systole

Answer 10

• Squeezing blood out of ventricles - Ventricles are contracting and aorta is expanding - Valves between atriums are closed - Blood leaves through aorta (body) and pulmonary artery (lungs)

Question 11

Diastole

Answer 11

• Dumping blood into ventricles - Ventricles are relaxing and aorta is contracting

Question 12

Systole BP

Answer 12

• Pressure generated by left ventricle into aorta and arterial tree - Measured when first sound is heard

Question 13

Diastole BP

Answer 13

• Pressure generated by blood remaining in arterial tree when ventricles are relaxed - Measured when last sound is heard

Question 14

Inflating the BP Cuff

Answer 14

• Tighten the knob and squeeze the pump - Ensure you no longer hear sounds

Question 15

Effect of Repeated Cuff Inflation

Answer 15

• Increases BP