Blood Pressure

Blood Pressure is the force exerted by the blood against the vessel wall
-the standard unit of measuring blood pressure is called
millimeters of mercury (mmHg) , the measurement indicates the
height to which the bold pressure can raise a column of mercury.
-Systolic Pressure the pressure of the blood against the arterial walls when the
ventricles of the heart contract. The normal systolic blood pressure in a
healthy adult is 120 mmHg.
-Diastolic Pressure the pressure during which the ventricles relax, the average
Diastolic pressure in a normal adult is 80 mmHg.
The difference between the systolic and diastolic pressure is the pulse pressure
if the BP is 120\80 , the pulse pressure is 40 mmHg.
Normal Blood Pressure

Age Normal Arterial Pressure

Infant 50\40 80\ 50

Children 87\48 117\64

Adult 110\70 130\90

Sites for taking Blood Pressure

Left or Right arm, on the antecubital space
Left or Right leg, on the popliteal space
Dorsalis pedis
Contraindications
1.patient’s post-surgery on breast, axilla, shoulders, or hands
2. affected arms with venous access, device such as AV shunt and IVF
3. patients with injury or disease to the shoulder, arms, hands such as trauma, burns
Or applications of cast or bandage.

Purpose
To aid in diagnosis
To observe changes in client’s condition.

PROCEDURE
1. Assemble the sphygmomanometer and stethoscope.

2.Determine the proper cuff size

-the proper cuff size is necessary to the correct amount of pressure is applied over
the artery.
3.Wah your hands.
-washing removes the microorganisms to prevent transmission to the client .
4.Explain the procedure to the client.
-explanations reassure the client.
5.Assist the client to a comfortable sitting position, with arm slightly flexed, forearm
supported at heart level and palm turned up.
-having the arm above heart level would produce a false low reading, This position
Facilitates cuff application
6.Expose the arm fully.
-exposing the upper arm ensures proper cuff applications.
7.Palpate the brachial artery. Position the cuff 2.5 cm (1 inch) above the site of brachial
artery pulsation (antecubital space)
-pressure applied directly to the artery will yield most accurate readings.
8.Be sure the cuff is deflated, wrap the cuff evenly and snugly around the upper arm.
-this ensure the proper pressure will be applied over the artery.
9.Be sure the manometer is positioned at the eye level.
-eye level placement ensures accurate reading of mercury level.
10. Place the stethoscope earpieces in the ears and be sure sounds are clear and not
Muffled.
-each earpiece should follow the angle of the examiner’s ear canal to facilitate
hearing.
11. Locate the brachial artery and place the diaphragm (or the bell) of the stethoscope
Over it.
-proper stethoscope placement ensures optimal sound reception, with the use of bell
Low-pitched Korotkoff sounds heard clearly.
12. Close the valve of the pressure bulb clockwise until tight.
-tightening the valve prevents air leak during inflation.
13. Inflate the cuff to 30mmHg above the client’s normal systolic pressure
-proper cuff inflation ensures accurate pressure measurement.
14. Slowly release the valve, allowing the mercury to fall at the rate of 2-3 mmHg per
Second.
-too rapid or slow decline in the mercury level may lead to an inaccurate reading.
15. Note the point on the manometer at which the first clear sound is heard.
-the first Korotkoff sound indicates the systolic pressure.
16. Continue to deflate the cuff gradually, noting the point at which a muffled or
Dampened sound appears
 -the fourth Korotkoff sound may be recorded as the diastolic pressure in adults
With hypertensions.
17. Deflate the cuff rapidly and remove it from the client’s arm unless you need to
Repeat the measurement.
-continuous cuff inflation causes arterial occlusions, resulting in numbness and
tingling on the client’s arm
18. If repeated the procedure, wait for 30 seconds,
-the delay prevents venous congestion and falsely high readings.
19. Fold the cuff and store it properly.
-proper maintenance of supplies contributes to instrument accuracy.
20 Assist the client to the positions he prefers and cover the upper arm.
This maintains the client’s comfort.
21. Record the blood pressure result in the jot down notebook.
-vital signs should be recorded immediately before they are forgotten.
22. Document the results in the TPR sheet. Report to the clinical instructor or staff
nurse for any abnormal results and unusuality’s.