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Blood pressure is the force
exerted by the blood against the arterial walls.
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The blood pressure asses
- cardiac output: how much heart pumps out
- peripheral resistance
- blood volume
- blood viscosity
- vessel wall elasticity
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systolic pressure
- measures the highest pressure of fluid in the blood vessels. squeezing (contracts)
- blood is ejected from the heart and into arteries.
- normal 100-120 mmHg
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diastolic pressure
- lowest resting pressure of fluid in the blood vessels. resting/ when the heart is filling. BP falls to its baseline level.
- 60-80mm Hg
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pulse pressure
the difference between the systolic and diastolic pressures.
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Prehypertension
- High risk to develop hypertension. Intervention: healthy lifestyle
- 120-139/80-89
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Hypertension Stage 1
- Persistently elevated blood pressure.
- factors: obesity, increased sodium intake, smoking, and decreased exercise
- 140-159/90-99
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Hypertension stage 2
160+/ 100+
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Prehypertension and hypertension1&2 is determined by
the most out of range number.
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Hypotension
- BP under 100/80
- Factors include loss of blood volume and failure in heart muscle to pump adequately
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orthostatic hypotension
- decrease in BP that occurs when one stands up causing a decrease in blood flow to the brain.
- Characteristics: dizzy and fainting.
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Factors that influence BP
- age: increase in older pts
- stress and emotion: increase bp
- medication, gender, exercise, body position, vasodilation/vasoconstriction.
- Head injuries and change in blood volume: decrease bp
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sphygmomanometer
proper cuff size: Length of bladder 80% around arm and width 40% around the arm.
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False low reading
bladder or cuff is too wide, too large, or if the arm is above heart level
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false high reading
too narrow, too short, too small, cuff is too loose, uneven, or arm below heart level.
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Stethoscope
- ear pieces point to your nose. clean bell surface with alcohol before each use
- Diaphragm: large, high pitched sounds (heart and lungs)
- Bell: Small, low pitched sounds (stomach)
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Steps for baseline BP
- explain procedure
- client should rest for 5 min before measurement
- wash hands
- pt arm at heart level and feet flat on the floor
- expose the arm
- locate the brachial artery
- place cuff 1in above the artery center of the cuff bladder
- inflate cuff until you feel the pulse disappear and add 30 mmHg
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assessment of systolic and diastolic pressure
- stethoscope over brachial artery
- inflate cuff estimate systolic pressure: +30mmHg
- release pressure valve
- note point you here the first Korotkoff sound: systolic
- note point where the sound disappears: diastolic
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pumping up the BP cuff too high
at the beginning of the measurement will raise the blood pressure
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Sites to avoid
- pt that has had breast surgery on that side
- pt has an IV on that arm
- pt has a FISTULA used for dialysis in that arm.
The popliteal artery can be used if needed
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