AUBREY ROSE A.

VIDON

BSN 3Y1-2

COURSE UNIT #1

1. Consider the three types of knowledge on the study guide, in respect of the
activity of recording of a person’s blood pressure, answer the following question below:

A. What is the propositional knowledge (theories) that underpins the activity?

The study of blood pressure measurement has been of slow growth. The literature of the subject
in past years shows how varying types of measuring instruments were employed, how the
readings of systolic pressure obtained by them differed with the type of instrument; how with the
same instrument discordant readings were obtained from arteries in different situations, where
equality or something approaching to equality of reading might have been expected.

Much attention has also been given to the fixing of the diastolic standard. Here also
disagreements were to be met with, disagreements both on the nature of the auditory and on
the nature of the oscillatory index. Recent work, however, has made possible methods of
accurately determining both the systolic and tile diastolic pressure in the human subject.

Considerable progress, apart from the fixing of standards, has been made in the theory of blood
pressure measurement. A wider knowledge of the factors involved flow renders capable of
explanation many of the difficulties and inconsistencies of blood pressure measurements. Let us
consider first the theory involved in the use of schemata in the elucidation of the phenomena of
blood pressure measurement. Such schemata aim at the simplification of the factors involved.
The schemata used by Erlanger, by Mac William and his co-workers consisted of a compression
chamber filled with water in which an artery was placed, and through this artery flow of water
was maintained under a pressure made to pulse from diastolic to systolic level. A constant
peripheral resistance was arranged to impede the flow from the artery. In the latest schema
used by Erlanger the resistance is infinite, and there is no flow.

Now all these schemata simplify the factors involved in blood pressure measurement, but they
neglect a highly important factor which Flack, Hill, and McQueen have drawn attention to
namely, the necessity of providing a peripheral resistance which should increase pari passu with
the increase of the compression pressure, thereby approximating closely to the physical
conditions which pertain to the use of the armlet on the human being. By the provision of such a
resistance Hill, Flack, and McQueen were able to explain the increase in the amplitude of the
pulse tracing (known to clinicians) that is obtained from the radial artery at the wrist when the
armlet is made to compress the upper arm with pressures varying from 0- to just below diastolic
pressure; they were also able to elucidate the mechanism of production of the dull (Korotkoff)
sounds which are heard on auscultation of the artery below the armlet. They showed that the
pulse-wave passing under the compressing armlet was actually augmented as the compressing
pressure rose from 0- to just below diastolic pressure, and this augmented pulse-wave stretched
the arterial wall beyond the normal, and so gave rise to those dull tension sounds which are
heard when the compression is below the diastolic pressure. Thus, when Erlanger and Mac
William simplify their schemata and make the peripheral resistance either a constant or an
infinite resistance, they appear to us to ignore one of the most essential physical factors
involved, and lose thereby knowledge of an essential part of the phenomenon of the Korotkoff
sounds-namely, the mechanism of the production of the dull sounds.

B. What is the propositional knowledge that you would need to be able to complete the
activity?

In order to complete the activity, we need to do the following procedures:

 To begin blood pressure measurement, use a properly sized blood pressure cuff. The
length of the cuff's bladder should be at least equal to 80% of the circumference of the
upper arm.
 Wrap the cuff around the upper arm with the cuff's lower edge one inch above the
antecubital fossa.
 Lightly press the stethoscope's bell over the brachial artery just below the cuff's edge.
 Some health care workers have difficulty using the bell in the antecubital fossa, so we
suggest using the bell or the diaphragm to measure the blood pressure.
 Rapidly inflate the cuff to 180mmHg. Release air from the cuff at a moderate rate
(3mm/sec).
 Listen with the stethoscope and simultaneously observe the sphygmomanometer.
 The first knocking sound (Korotkoff) is the subject's systolic pressure.
 When the knocking sound disappears, that is the diastolic pressure (such as
120/80).Record the pressure in both arms and note the difference; also record the
subject's position (supine), which arm was used, and the cuff size (small, standard or
large adult cuff).
 If the subject's pressure is elevated, measure blood pressure two additional times,
waiting a few minutes between measurements.
 A BLOOD PRESSURE OF 180/120mmHg OR MORE REQUIRES IMMEDIATE
ATTENTION!

C. Any personal knowledge you have regarding the activity? And what do you think you
learned from this activity?

I know that maintaining a healthy bloody pressure is very important because the higher
your blood pressure is the higher your chances of having health issues are. All of your body's
important organs, such as your brain and heart, receive nutrients and oxygen through your
blood flow. The beating of your heart is what pushes your blood through your blood vessels
allowing it to flow through your body to all your important organs. Your blood vessels will adjust
and become either narrower or wide in order to maintain a healthy blood pressure. What I have
learned in this activity is the importance of accurately measuring the blood pressure because
small inaccuracies can have consequences for patients. Underestimating true blood pressure by
5 mm Hg could mislabel a patient with prehypertension when true hypertension is present. That
helps ensure that all patients with any form of high blood pressure is both diagnosed and
treated, while minimizing the number of patients that could be wrongly diagnosed.