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Lab Activity 26 Blood Pressure & Pulse Portland Community College BI 232 Pulse Radial Pulse Carotid Pulse Brachial Pulse Pulse Posterior Tibial Pulse Dorsalis Pedis Pulse Blood Pressure Cuffs BP cuffs come in different sizes.

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Lab Activity 26

Blood Pressure & Pulse

Portland Community College

BI 232


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Pulse

Radial Pulse

Carotid Pulse

Brachial Pulse


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Pulse

Posterior Tibial Pulse

Dorsalis Pedis Pulse


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Blood Pressure Cuffs

  • BP cuffs come in different sizes.

  • Be sure to choose the one that is appropriate for the patient

Large Adult

Infant


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Measuring Blood Pressure

  • Most cuffs are marked with an O or an arrow. This should be placed near the artery.


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Measuring Blood Pressure

  • Place the BP cuff snugly on the patient's arm.

  • Check to make sure you have found the artery.

  • Line the mark on the cuff up with the artery


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Measuring Blood Pressure

  • Stethoscope: Note how the ear pieces slant slightly in one direction.

  • Make sure the ear pieces on the stethoscope are point away from you when you put them on.

  • Place stethoscope on the artery, tucked slightly under the cuff


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WRONG TECHNIQUE

Measuring Blood Pressure

  • The cuff should be placed at the level of the heart.

  • The patients arm (or leg) should be completely relaxed.

    • Resting on the table or in their lab is helpful

CORRECT TECHNIQUE


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Inflate the Cuff

  • A Grasp the bulb so that your thumb can easily access the valve.

  • Turn the valve to the right to tighten it and pump up the cuff, turn it to the left to loosen it and deflate the cuff.


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Measuring Blood Pressure

  • Pump up the cuff until the sphygmomanometer reads 180 to 200.

  • Loosen the valve to let a little of the air out.

  • Listen for the first heartbeat, that is the top number (systolic BP)

  • Continue to listen until there are no more heartbeats. The last beat you hear is the bottom number (diastolic BP)

  • Let the air all the way out and remove the cuff.


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Video Demonstration for Measuring Blood Pressure

  • http://www.uams.edu/csc/programs/orientation/bloodPressure/TakingBP1.mov


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Normal Blood Pressure

  • Reference:

    • August 2004, National Heart Lung and Blood Institute – Diseases and Conditions Index

    • http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhatIs.html

  • For adults 18 and older who:

    • Are not on medicine for high blood pressure

    • Are not having a short-term serious illness

    • Do not have other conditions such as diabetes and kidney disease

  • Systolic BP: Less than 120

  • Diastolic BP: Less than 80


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Pre-Hypertension

  • Systolic BP: between 120-139

  • Diastolic BP: between 80-89

    • Examples: 118/82, 128/89, or 130/86

    • If your blood pressure is in the pre-hypertension range, it is more likely that you will end up with high blood pressure unless you take action to prevent it.

  • Note: When systolic and diastolic blood pressures fall into different categories, the higher category should be used to classify blood pressure level.


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Hypertension

  • Stage 1

  • Systolic BP: between 140-159

  • Diastolic BP: between 90-99

  • Stage 2

  • Systolic BP: 160 or higher

  • Diastolic BP: 100 or higher


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Hypotension

  • Hypotension is a subnormal arterial pressure.

    • There is not enough pressure to adequately perfuse the tissues.

    • There is usually a mean arterial pressure (MAP) below 60 mmHg.

      • MAP= diastolic + 1/3(systolic-diastolic)

        Example: BP= 120/70

        MAP= 70 + 1/3(120-70)= 86.6

  • People who are chronically hypertensive may feel symptoms of hypotension if their mean arterial pressure drops by 40 mmHg, even if the absolute value is still over 60.


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Orthostatic Hypotension

  • Orthostatic hypotension exists if the systolic drops by 20mmHg, or if the diastolic drops by 10mmHg upon sitting or standing for 3 minutes.

  • Symptoms: headache, dimming of vision, weakness, lightheadedness, that occur as go from lying to sitting or standing position.

  • Causes: volume depletion, diabetes, medications such as anticholinergics, Parkinson's, etc.


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Measuring Orthostatic BP

  • Determine the blood pressure in the supine position.

  • Sit the subject up, wait 3 minutes, and check the blood pressure again.


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The End

The End


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