Please get your assigned computer. Do not turn on until instructed.

 The measurement of the force of blood against artery walls Force comes from the pumping of the heart If arteries are hardened or narrowed, this force might be increased to pump the blood throughout the body

 Done by listening for two sounds within a stethoscope – the first sound and the change in sound/or in some instances the last sound  1 st sound – systolic BP  2 nd sound – diastolic BP Aneroid Sphygmomanometer

 Systolic – measures the pressure in an artery when the heart is contracting  Diastolic – measures the pressure in an artery when the heart relaxes between contractions

Top number (systolic) is measured first, then the bottom number (diastolic) 120/80 is a normal blood pressure

Reading an Aneroid Sphygmomanometer Practice

 Normal range of BP = 100/60 to 140/90  90/60 = hypotensive Dizziness, light-headedness, might faint Medications, extremely fit, illness, injury  140/90 = hypertensive “silent killer,” there are often no symptoms May result in a stroke Overweight, emotional upset, history, pain, illness, medication Normal Pulse Pressure mm Hg (systolic – diastolic)

BP mmHgNormalPrehypertensionHypertension Systolic (top number) Less than or higher Diastolic (bottom number) Less than or higher

 Increases the risk of coronary heart disease (which leads to heart attack) and stroke  Can occur in children or adults  Particularly prevalent in: African Americans middle-aged and elderly obese people heavy drinkers Mercury Sphygmomanometer

 Sphygmomanometer (blood pressure cuff) Must fit the arm properly Gauge should be calibrated and needle on zero  Stethoscope Eartips point toward nose Must be cleaned after each use!

To prevent spread of microorganisms, clean eartips and diaphragm after each use with alcohol. Point eartips toward the nose when placed in the ears.

 You will need headphones for this lab  Log into AISD Moodle  Locate Clinical Skills  Click on Blood Pressure Practice  Read Introduction  Read patient history then, practice taking BP for each patient

 Sphygmomanometer Must fit the arm properly; width of cuff = with of upper arm Gauge should be calibrated and needle on zero  Stethoscope Eartips point to nose Must clean ear tips and diaphragm with alcohol wipe after use

1. Person should be seated or lying down 2. Should have rested for minutes prior to reading 3. For adults, use arm, for infants, use leg 4. Excess air should be squeezed out of the cuff 5. Valve should be closed, but easily able to be opened 6. Two technique options:

 Find radial pulse  Pump cuff until pulse no longer palpated  Pump another 30 mmHG higher  Place diaphragm of stethoscope on brachial artery about ½ - 1 inch above the elbow  Release the valve and listen for the two measurements – slowly deflating the cuff

 Find brachial artery and put diaphragm over the site  Pump cuff to 120 mmHg and listen for the heart beat  Once heard, pump another 30 mmHg and listen again  When pulse is no longer heard, then pump another 30 mmHg and slowly deflate, listening for the two measurements

 Manual BP video Manual BP video  Self Manual BP video Self Manual BP video  Automatic Monitor video Automatic Monitor video  If reading is uncertain, wait 30 to 60 seconds before re-measuring  Record the reading and report any abnormalities

 Practice taking your BP – chart  Practice taking BP of five students – chart  Practice taking BP with an automatic monitor on at least two students –chart  Review Positioning PPT – make Cornell Notes If reading is uncertain, wait seconds before re-measuring! If still uncertain, switch arms.