Practical 3

Question 1

What is the method for measuring Resting Blood Pressure (manual method)?

Answer 1

1. Inform the participant what you are about to do and any discomforts that maybe felt. Patients should be quietly seated for at least 5min prior to measuring.
2. Set up so that the participants arm is resting on a table and is level with the heart. The sphygmomanometer should be at eye level and turned away from the participant to avoid increase in blood pressure due to patient anxiety.
3. After gaining consent, remove or roll up any clothing that may be on the arm. Locate brachial artery and wrap the cuff around the persons upper arm. Make sure the cuff is on correctly (triangle needs to be placed on top of the brachial artery. The cuff should be positioned approx. 2-3cm above antecubital space. The cuff should not fall down once put on and you should be able to place two fingers between the skin and the cuff to make sure it is not too tight.
4. Turn on the sphygmomanometer and wait for it to go zero.
5. Put the earpieces in (mountains up) and check the stethoscope is turned ‘on’ by lightly tapping the on bell.
6. Make sure the air release knob on the pump is fully clockwise and the bell of the stethoscope is placed over the brachial artery and held in place. Have all this in place prior to pumping in air thus limiting time the client has the cuff inflated.
7. Inflate cuff to 180-200mmHg. The cuff technically needs to be inflated 40mmHg above systolic blood pressure.
8. Deflate cuff at a rate of 2-3mmHg per second and listen to the sounds through the stethoscope. Try to avoid movement of the fingers holding the bell in place as this will cause noise.
9. Identify the systolic & diastolic blood pressure according to phase 1 to 5 of Korotkoff sounds respectively.
10. Once diastolic blood pressure has been identified release the cuff fully and take it off.
11. Counsel the participant on their results (Your blood pressure was 125 over 85mmHg & this is in the high normal range).

Question 2

What are the phases of Korotkoff Sounds?

Answer 2

Phase 1
-Onset of consecutive faint, clear tapping sounds with a gradual increase in intensity.
Phase 2
-Sounds change to swishing or blowing sounds.
Phase 3
-Sound becomes clearer & crisper, creating soft thuds that become louder.
Phase 4
-Sound becomes suddenly muffled & assumes a soft, blowing character that diminishes.
Phase 5
-Sound disappears.

Question 3

What are the resting blood pressure classifications for adults?

Answer 3

Optimal S=<120 D=<80
Normal S=120-129 D=80-84
High-Normal S=130-139 D=85-89
Grade 1 (mild) hypertension S=140-159 D=90-99
Grade 2 (moderate) hypertensio S=160-179 D=100-109
Grade 3 (severe) hypertension S=>180 D=>110
Isolated systolic hypertension S=>140 D=<90

Question 4

What happens when the patients systolic and diastolic pressure levels fall into different categories?

Answer 4

The higher diagnostic category & recommended actions apply.

Question 5

What is the assessment criteria for the queens college step test?

Answer 5

-Introduces self and role
•Hello, my name is Kate & I’m an Exercise Science Student
-Observes correct hand hygiene
•Gels hands prior and at completion of consultation
-Explains the procedure in a logical and correct manner
-Identifies safety considerations
•Tells client to place their whole foot in the middle of the step for every step
-Knows how to use/set up the metronome correctly
•Males: 96
•Females: 88
-Monitors symptoms and verbally supports and corrects client throughout the test
-Correctly measures HR post test
-Communicates post HR clearly and correctly