BLOOD PRESSURE

Recording of blood pressure

Definition:

Blood pressure is the force of blood at walls of vessels at which the blood is pushed out of heart.in various diseases the blood pressure of patient increases or decreases and some times poses alarming situation.it is a part of nursing job to record and note down the blood pressure of such patient.

Equipment Required

1. Sphygmomanometer (blood pressure instrument)
2. Stethoscope

Procedure

Patient should be either sitting or lying down.

• Intimate the procedure to the patient you are going to do.
• Roll patient,s sleeve above or slip sleeve off conveniently.
• The patient is instructed to extend his arm if conscious.
• Apply the cuff sphygmomanometer smoothly and not too tightly.
• The manometer is placed on the bed side table in a position at the level of your eyes.
• The base of sphygmomanometer and cuff attached to patient arm should be at the same level.if the patient is sitting the B.P. instrument should be hold by an assistant to bring the level.otherwise it will not record the correct reading.
• Locate the brachial artery pulsation at elbow where it bifurcates into two branches.
• Hold the stethoscope on arm at this point with left hand.
• Close air valve screw with right hand,pump bulb to inflate cuff untill artery cases to pulsate.
• Watch mercury coloumn closely and continue pumping air to inflate cuff about 10 to 15 mm higher than where the artery started stopping pulsation.

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• With right hand release valve screw slightly and slowly,(The mercury column should not fall more than 5mm per second).
• Note carefully the exact reading of mercury column where the first sound (thumping or snaping) is heard.Record this as systolic blood pressure.
• Allow the mercury to fall slowly untill the sound headed suddenly gets softer and diminished gradually.this point where it gets softer is recorded as diastolic blood pressure.
• Release the pressure completely and repeat the procedure for mercury to zero and then again raise it.
• Record the B.P. reading in chart or patient,s history sheet with time and date.

Palpatory method to record systolic pressure

By this method only systolic blood pressure can be recorded.For this purpose no stethoscope is required.inflate the armlet or cuff untill radial pulse at wrist is not felt. First radial pulse is felt and while putting the finger above radial artery the cuff is inflated.Through valve release air to allow fall of mercury column.Now concentrate feeling for return of pulse.This is the systolic pressure.For mercury manometer always mentionthe reading in millimeter of mercury or as for example 120/80mm of hg.By palpatory method it is about 5 to 10 mm higher than auditory method.In common practice auditory method is advisable.

Android manometer

This is a sphygmomanometer having a dial system for reading in place of mercury column.This is convenient and handy for use and compact for handling.After binding the cuff or armlet the dial for reading is fixed with the armlet at it's place.Then the procedure is same to record.This mechanism is liable to give false reading especially with longer of time.It is therefore important to correct it, from time to time against a mercury manometer to make sure that it is accurate.