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BP is measured using BP cuff, sphygmomanometer

and stethoscope.
The sphygmomanometer indicates the pressure of
air inside the bladder.
BP sounds are difficult to hear among clients who
are infants, obese and in shock.
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neroid- calibrated dial with needle that points
calibration.
Digital- eliminates the need to listen for sounds of
the clients systolic and diastolic using stethoscope.
It should be calibrated periodically to check
accuracy.
BP cuff consists of a rubber bag that can be inflated
with air called bladder.
It has two tubes and is covered with cloth.
BP cuff is made up of undistensible material, to exert
equal pressure.
BP cuff varies in sizes
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CIvcumIevence
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22- 26 cm SmnII nduIf l2 x 22 cm
2?- 34 cm AduIf cuff l6 x 30 cm
35- 44 cm !nrgo nduIf l6 x 36 cm
45- 52 cm AduIf fhIgh l6 x 42 cm
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&sual- upper arm using brachial artery and
stethoscope
Thigh if:
1. BP can't be measured on either arm
2. BP in one thigh is to be compared with BP on
other thigh
Do not use limb if:
1. Shoulder, arm, hand, hip, knee or ankle is injured
2. Cast or bulky bandage is present on the limb
3. Has had surgical removal of axilla or hip or nodes
on that side
4. Has IV infusion on that limb
5. Has an arteriovenous fistla
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Direct/ Invasive monitoring
Involves insertion of catheter into brachial/
radial/ femoral artery
rterial pressure is presented in a wavelike
form on monitor
Correct placement= result is highly accurate
Indirect
uscultation- commonly used in hospitals,
clinic and homes. It is relatively accurate.
orotkoff's sound- series of 5 sounds produced by
blood within the artery with each ventricular
contaction.
5 phases
1. Sharp tapping
2. Swishing- whooshing
3. Thump softer than tapping in 1
4. softer blowing muffled sound that fades
5. Silence
Palpatory- used when korotkoff's sound can't be
heard and equipment to amplify the sound is not
available or prevent misdirection from pressure of
auscultatory gap.
ucultatoty gap- occurs particularly in
hypertensive clients.
- It is the temporary disapperance of sounds
normally heard over brachia artery when cuff
presure is increased and reapperance when at
lover level.
- Temporary sounds disapperance occurs at
later part of phase 1 and 2 and may cover range
of 40 mmHg.
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orearm supported at heart level and palm up.
Expose the upper arm completely
Wrap deflated cuff snugly around upper arm with
center of the bladder over brachial artery. Lower
border of cuff should be about 2 cm above
antecubital space.
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Cuff too narrow Erroneously high
Cuff too wide Erroneously low
rm unsupported Erroneously high
Insufficient rest before assessment Erroneously high
Repeating assessment too quickly Erroneously high systolic/ low diastolic
Wrapped too loosely or unevenly Erroneously high
Deflating too quickly Erroneously low systolic & high diastolic
Deflating too slowly Erroneously high diastolic
ailure to use the same arm consistently Inconsistent measurements
rm above heart level Erroneously low
ssessment immediately after meal/ client
smokes/ in pain
Erroneously high
ailure to identify auscultatory gap Erroneously low systolic & Erroneously low
diastolic