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Blood Pressure
• Force exerted on the walls of the artery. Created by the pulsing
blood under pressure of the heart.
• BP = CO x R
• Systolic- Peak and maximum pressure of ejection of blood from the
heart into the aorta. This is the top number.
• Diastolic- The minimal pressure remaining the heart when the heart
relaxes. This is the bottom number.
• Recorded as a ratio Ex. 120/80
Equipment for BP
Measuring BP
• Pulse pressure- Difference
between the systolic and
diastolic. ( 120/80 – Pulse
pressure 40)
• Size matters-False high if cuff
too small, false low if cuff is
too loose
• Don’t take BP on arm with IV,
sling, surgery, mastectomy,
renal dialysis shunt, etc.
Electronic BP Readings
• Easy to use
• Does not count
• Do not use for
patients with
irregular pulse
Alternative Sites
• Use popliteal artery
• Place bladder of cuff on posterior part of leg
Measuring BP
Measuring BP
• Cuff must be appropriate
• Cuff should be snug, not
• Do not put stethoscope
under cuff ( place cuff 1-2
inches above elbow)
Measuring BP
• Pt should be sitting or
lying with arm at the
level of the heart
• Distinguish Korotkoff
sounds (sounds heard
when taking BP) from
• Make mental note of
systolic and diastolic
Measuring BP
• If unsure of reading,
wait 30 seconds and
recheck-if unsure,
have someone else
check with you
• Loosen cuff even if to
be checked q 15
• Make sure all air is out
cuff before applying
Factors Affecting BP
Fluids (IV or PO) -increases
Blood Transfusions- increases
Hemorrhage –decrease
RACE-Blacks and Hispanics
more prone increase
• Age
• Heredity-increased chance if
immediate family history
Alterations in Blood Pressure
Hypertension –
Most common alteration in BP
Most often asymptomatic
Characterized by persistently
elevated BP
Noted when diastolic is greater
than 90 mm/Hg and systolic is
greater than 140mm/Hg
Optimal BP for 18 y/o and older
is less than 120/80mm/Hg
Alterations in Blood Pressure
• When systolic blood pressure falls to 90 or
• Orthostatic (Postural) Hypotension- Occurs
when a normotensive person develops
symptoms and low blood pressure when rising
to an upright position.