Download Pulse and Blood Pressure

Essentials of Healthcare
 The
pressure of the blood felt against the
wall of an artery as the heart beats
• Felt most easily in arteries, especially those that
can be gently pressed against a bone
 The
pulse lets us know how the
cardiovascular system is meeting the
body’s needs
 Radial
pulse is most commonly used and
is found in the inner aspect of the wrist
 You must note 3 things when checking a
pulse
• Rate or speed
• Rhythm (regular or irregular)
• Volume (strong, weak, thready, bounding)
 You
must record date and time pulse was
taken in addition to the above findings
 Pulse
rate is measured as the number of
beats per minute
 Counted for one full minute and recorded
as a number
 Followed by the abbreviation bpm (beats
per minute)
 Varies by individual
• age, sex, body size and illness
 Normal
Ranges
• Adult 60-80
• Children 7+ 70-100
• Children 1-7 80-100
• Infants 120-160
 You
must report
• Tachycardia (over 100 beats per minute)
• Bradycardia (below 60 beats per minute)
• Irregularities in rhythm or volume
 May
be affected by many things
• illness
• Emotions
• Age
• Exercise
• Elevated temperature
• Drugs
• position
 Measured
by counting the heart
contractions
 Left side of chest
 Between 5/6 ribs
 Just below left nipple
 Under left breast in
a female
Listen for lub dub…
 The sound you hear
are the heart valves
opening and closing
 Always
count for one full minute
 Who needs an apical pulse checked?
• Whenever pulse deficits exists or is suspected
• Before meds that change heart rate or rhythm
• On any child 12 months or younger
 Can be hard to feel/count a faster pulse
• Whenever radial pulse if irregular or if you are
uncertain of the accuracy of the radial pulse
• On any child in which it is difficult to get a radial
pulse
 This
occurs when the heart is too weak and
does not pump enough blood to produce a
pulse or when the heart beats too fast, not
allowing the heart to fill with blood between
beats.
 The apical rate would be greater than the
radial rate.
 How do you check a pulse deficit?
• One person checks apical rate while another checks
radial rate. If the rates are different, a pulse deficit
exists.
 Measures
the force of blood against the
artery walls
• Blood pressure is measured in mmHg (millimeters of
mercury)
 Systole
(systolic reading)-the force of blood
against the artery walls during ventricular
contraction-working pressure
 Diastole
(diastolic reading)-the constant
pressure in the walls of the arteries-resting
pressure
 What
elevates the BP?
• Exercise
• Eating
• Stimulants
• Stress, fear, anxiety
• Arteriosclerosis, high
cholesterol, diabetes
• Pain
• Obesity
 What
lowers BP?
• Rest
• Depressants
• Weight loss
• Shock
• Grief
• Dehydrations
• Diuretics
 What
does the equipment look like?
Stethoscope
Aneroid
sphygmomanometer
Electronic
sphygmomanometers
Mercury
sphygmomanometers
 Cuff
is placed directly over the brachial artery
(1 inch above the antecubital space)
 Systolic pressure is the first regular sound you
hear
 Diastolic pressure will be the change or last
sound you hear
 Pulse pressure will give you information on the
condition of the arteries in the body
• The difference between the systolic and diastolic
pressure
 Normal Ranges-recorded as a fraction
• Average resting pressure120/80
• Normal Systolic Pressure Range100-140
• Normal Diastolic Pressure Range60-90
• Hypertension-pressure above 140/90
• Hypotension-pressure below 100/60
•
The systolic and diastolic values should
be looked at separately to determine
normal
 Can
you use any arm to check BP?
 No. When would you not use an arm?
If it has an IV line or other device inserted
Is being treated for burn, fracture, etc
Has dialysis access device
Is on the same side as a recent mastectomy or
other surgical procedure
• If the arm is paralyzed, injured or has edema
• If the arm has a pulse oximeter on it
•
•
•
•
 Inaccurate
or erroneous blood pressure
readings are due to:
•
•
•
•
•
•
•
Wrong size cuff
Improperly wrapped cuff
Incorrect positioning of the arm
Not using the same arm each time
Not having the gauge at eye level
Deflating the cuff too slowly
Mistaking an auscultatory gap for the diastolic
pressure
 Make
sure the gauge is at eye level
 It should not be tilted
 The
gauge
• Each small line represents 2mm Hg
• Each large line represents 10mm Hg
 What
do I report?
• If you were unable to get the reading
• If it is higher than a previous reading
• If it is lower that a previous reading
• If the site where the BP was taken was other than
the brachial artery
• The position of the patient (sitting, standing,
lying down)
Orthostatic, or postural, hypotension occurs when
there is a sudden drop in both systolic and
diastolic pressures when an individual moves from
a lying to a sitting or standing position
 Your blood vessels can’t compensate quickly
enough to the change in position
 Dizziness, lightheadedness and blurred vision may
happen
 Patients may need orthostatic blood pressures
taken to see if this condition is occurring

• We do them lying, sitting then standing to determine if there is
a drop
 Electronic
blood pressure monitors are
not for everyone
 Do not use on those with:
• Extreme hypertension or hypotension
• Very rapid heart rates
• Excessive body movements or tremors
• Irregular heart rhythms or dysrhythmias
Practice
measuring pulse
and blood
pressure
following your
check off sheets