Lab Instruction Manual: Blood Pressure

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Blood Pressure Sorry, I m finding your heading confusing. Is this a book, or a manual? Add names somewhere.
HOW TO GET AN ACCURATE BLOOD PRESSURE MEASUREMENT
Difficulty Level: The following manual will show provide you with step-by-step instructions on how to correctly measure blood pressure with an aneroid sphygmomanometer. Monitoring blood pressure is an essential part of any physical examination, and it provides vital information about your patient. This information can be used for a variety of things, such as, assessing health and cardiovascular risk factors and constructing of an exercise program. Measuring blood pressure is a relatively simple procedure that takes between 10-15 minutes. Who should do it? Whos the audience?

MATERIALS
(1.) Stethoscope

(2.) Sphygmomanometer

(3.) Stop watch (iPhone)

(4.) Measuring tape

(5.) Chair with arm rest area, in subsequent photos. Nice!

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TIPS
A different heading would say more, maybe, before you start? Use caution when inflating the blood pressure cuff. Over inflation may lead to burst blood vessels and cause other severe injuries. o Ensure the cuff of the sphygmomanometer has a proper, comfortable fit on the participant. o Avoid smoking or drinking caffeine 30 minutes prior to measuring blood pressure. Hee, hee. This construction means the nurse shouldnt smoke . . .

INSTRUC TIONS
STEP 1 Begin by having your subject sit quietly in a comfortable chair for 5 minutes. Insure that the chair has a back and an arm rest. Instruct your subject to relax as much as possible.

Clear design!

STEP 2 Position your subjects arm at heart level for the 5 minute resting period. Which arm? Does it matter?

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STEP 3 Use a measuring tape to measure the circumference of your subjects arm. This measurement will be used to select the proper size cuff for your subject. Measure the upper arm around its thickest part; about half way between the shoulder and elbow. Use Table 16.1 to find the appropriate cuff size for your subject. OK, if this is Chap. 13 of your book, then this should be figure 13.1.

ACK! Where did you find this table? Citation!

STEP 4 Select the proper cuff. The cuffs air bladder should cover approximately 80% of the subjects arm. Look up apostrophe use to show possession. Save red (below) for caution or danger. Try blue, green, etc.

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* The air bladder is a rubber bladder inside of the blood pressure cuff. When attached to the arm and inflated, the bladder applies pressure on the arm.

STEP 5 Locate your subjects Brachial Artery. The Brachial artery is located in the center of the elbow crease. If not visible with the naked eye, feel for the artery by gently pressing the index finger into the elbow crease. * Imagine pressing on the side of a drinking straw that is lying flat on a table. When you feel that in your subjects arm, you have found their Brachial artery. You may mark the artery with a pen if that will assist you.

STEP 6 Attach the blood pressure cuff to your subjects arm. Use the indicator lines on the cuff to center the air bladder over the Brachial artery. The lower edge of the cuff should be approximately 1 inch (2.5 cm) above the elbow crease.

great photos, team!

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STEP 7 Position the pressure gauge so that you can easily read the dial. Often times this is done by clipping the gauge to the outside of the cuff after the cuff has been positioned on the subject.

STEP 8 Put on your stethoscope.

STEP 9

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Place the diaphragm of the stethoscope in the elbow crease over the brachial artery. * Apply firm pressure but DO NOT indent skin.

STEP 10 Close the air release valve on the pressure pump by turning it clockwise until it no longer turns.

STEP 11 Instruct your subject to relax, remain quiet and not to move while you measure blood pressure. parallelism

STEP 12

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Inflate the blood pressure cuff by squeezing the pressure pump until the pressure gauge reads 160 mm hg.

STEP 13 When the pressure gauge reads 160 mm hg, slowly turn the pressure release valve counterclockwise to release the pressure. Release the pressure at a rate of 2 to 3 mm hg per second. Begin listening for thumping noises in the stethoscope. These noises will resemble the sound of a typical heart beat.

STEP 14 Watch the indicator on the pressure gauge fall; make mental note of the value indicated on the pressure gauge where you hear the first and last sounds. The first sound you hear will indicate systolic blood pressure. The last sound will indicate diastolic blood pressure. Continue listening until the pressure gauge falls another

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10-20 mm hg after the last sound you hear. * Systolic blood pressure represents arterial pressure while the heart is contracting. Diastolic blood pressure represents arterial pressure while the heart is relaxing.

STEP 15 Rapidly deflate blood pressure cuff by fully twisting the pressure release valve counterclockwise. Completely deflate the cuff.

STEP 16 Completely remove the blood pressure cuff.

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STEP 17 Have your subject rest quietly in the same comfortable position as in the initial resting period for 2 to 3 minutes.

STEP 18 Repeat steps 6 through 16. To assess resting blood pressure, two readings must be taken and averaged together.

STEP 19

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Take an average of the recorded values for each first and last sound. Add the two first sound values and divide by two. Add the two last sound values and divide by two. The numbers you calculate are the resting blood pressure. * See general Blood Pressure guidelines in Conclusions.

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CONSID ERATIONS
o One successful attempt does not mean you are a proficient tester. Proficiency and consistency in measurement comes only with thousands of trials. o After two or three measurement attempts, if no sounds are heard in the stethoscope upon inflating the cuff to 160 mm hg, deflate the cuff completely; re-inflate the cuff to 200 mm hg and continue the test as described. The absence of sound at 160 mm hg could be an indication of high blood pressure. o If there is a complete absence of sound or extremely muffled sound, re-adjust the position of the diaphragm on the stethoscope. Ensure the diaphragm is locked in place.

CONC LUSION
Once the average has been calculated, this represents the systolic and diastolic blood pressure. Use the following chart to stratify your subject's blood pressure. Your subject is now free to leave. Follow these instructions for each subsequent blood pressure test you administer.

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Instruction Manual Assessment Sheet*

Names: 1) Do the instructions have a clear, appropriate title? YES NO looks like Ill be reading a chapter about blood pressure, rather than learning how to measure blood pressure. 2) Does the introduction to the instructions o o State the purpose of the task? YES Describe safety measures or other concerns that readers should understand? YES the pressure is super high or super low? What should the nurse do?? o List necessary tools and materials? YES NO NO: what if NO
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3) Are the step-by-step instructions o o o o o Numbered? Expressed w/ active, imperative verbs? Simple, clear, and direct? Easy to followcould you do this procedure using this guide? YES YES YES YES NO NO NO NO
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Accompanied by appropriate citations? YES NO Eek! What sources did you use for the figure and to ensure you didnt leave any steps out?

Formatted: Highlight

4) Are the graphics o o o o Appropriate and clear? Located near their corresponding text? Accompanied by descriptive captions? Accompanied by appropriate citations? YES YES YES YES NO NO NO NO
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5) Does the conclusion o o Include any necessary follow-up advice? Some, but we could use emergency info too, like what to do in the case of extraordinarily high or low pressure. YES NO Include, if appropriate, a troubleshooting guide? YES NO YES NO

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6) Is the manual designed effectively, with adequate white space?

Formatted: Highlight

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*Assessment Sheet, adapted from Markels page 574

Assessment Overview (hint: start with a positive whats working here?): OMG you guys, I was so excited while I was reading this: its totally clear and beautifully designed. I feel like I could measure someones blood pressure with this guide. Unfortunately, you omitted citations for your figure and for your overall source. What guides or websites did you consult to ensure you didnt omit any steps?? Correct and resubmit by Nov. 15 for an 85.