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subsequent from the arm with the higher BP. Normally, the BP should vary by no
more than five mmHg between arms. The site where the BP was measured and
the position of the patient were recorded (e.g. right arm). The patient was also
informed of his or her BP value and had been explained what it means. The used
for periodic measurement, was emphasized and patients were encouraged to
measure BP at home to keep a written record of readings. (Textbook of Medical-
Surgical Nursing 11
th
Ed., Brunner & Suddarths)

2. Heart Rate (pulse) Monitoring
The pulse can be recorded anywhere that a surface artery runs over a bone.
The radial artery in the wrist is the point most commonly used to measure a pulse.
To measure a pulse, one should place the index, middle, and ring fingers over the
radial artery. It is located above the wrist, on the anterior or front surface of the
thumb side of the arm. Gentle pressure should be applied, taking care to avoid
obstructing blood flow. The rate, rhythm, strength, and tension of the pulse should
be noted. The pulsation was counted as one (1) full minute. Results should be
noted in the health chart ( Michigan Department of Public Health and the
Michigan Association for Local Public Health. Promoting Cardiovascular Health
in Michigan: Recommendations for Action. pp 35-37, December 1991).