Blood Pressure Assessment

blood pressure
The pressure exerted by the blood in the arteries is called blood pressure. An accurate measurement of blood pressure is an essential part of any complete health assessment. The first number recorded in a blood pressure measurement is the systolic pressure. Systolic pressure is the pressure of the blood at the height of the wave when the left ventricle contacts. The diastolic pressure is the pressure between the ventricular contractions, when the heart is at rest. This is the second number recorded in a blood pressure measurement.

Assessment of the Blood Pressure

- It is important to reassure the client that the procedure for taking blood pressure is generally quick and painless.
- The client should be at rest for at least 5 minutes before taking blood pressure.
- Place the client in a comfortable position.
- Things you need to use: blood pressure cuffs, a sphygmomanometer, and a stethoscope.
- Make sure to use a blood pressure cuff with appropriate size for the client's arm.
- Slightly flex the arm and hold it at the level of the heart with the palm upward.
- Place the cuff on the client's arm 1 inch above the antecubital area.
- Palpate the radial pulse.
- Inflate the cuff until the radial pulse is no longer palpable and now the reading. This is the palpatory systolic blood pressure.
- Auscultate the pulse in the brachial artery.
- Pump up the cuff until 30 mmHg above the palpatory systolic blood pressure (the one you noted earlier).
- Release the valve on the cuff carefully so that the pressure decreases at the rate of 2 to 3 mmHg per second.
- Note the manometer reading at each of the five Korotkoff phases.
- The first sound is recorded as the systolic blood pressure and the last sound is recorded as the diastolic blood pressure.
- Deflate the cuff rapidly and completely.
- Remove the cuff from the client's arm.
- Blood pressure should not be taken on the side with a mastectomy or shunt.
- If blood pressure cannot be measured in either arm because of disease or trauma, a thigh or leg blood pressure may be taken.

Factors that Influence Blood Pressure

These are the factors that influence blood pressure but are not limited to the following:
Age - newborns' systolic blood pressure averages about 78 mmHg that tends to rise through age 18 and then stabilizes. In older adults, blood pressure rates tend to rise again as elasticity of the arteries decreases.

Gender - females tend to have lower blood pressure than males of the same age after puberty and increases after menopause.

Race - American male of African ancestry over the age of 35 tend to have higher blood pressures than American males of European descent.

Obesity - blood pressure tends to be higher in people who are overweight and obese than people of normal weight of the same age.

Diurnal variations - blood pressure is usually lowest in the early morning and rises steadily throughout the day, peaking in the late afternoon or early evening.

Medications - a variety of medications may increase our decrease blood pressure.

Stress - this increases cardiac output and arterial constriction, resulting in increased blood pressure.

Physical activity - there is an increase in blood pressure when there is physical activity due to increase in cardiac output.

Cardiac output - the amount of blood ejected from the heart. It is equal to the stroke volume.

Blood volume - a sudden drop in blood pressure may signal sudden blood loss.

Peripheral vascular resistance - is the resistance against the blood as it does within the vessels.

Blood viscosity - When the total amount of form elements is high, the blood is more viscous or thicker. Thus more pressure is required to move the blood.

Vessel compliance - rigid, hardened articles, as are found with arteriosclerosis, are less responsive, and greater force is required to move the blood along.

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