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Samantha Kosmacki

SER 311 01 Testing and Exercise Prescription Laboratory

Module 1 Core Concepts

2 March 2021

Dr. Larouere
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Background

Blood pressure and heart rate are measured in order to evaluate the cardiovascular health

of an individual. Blood pressure is the measurement of the pressure of blood as it hits off of

blood vessel walls and arteries. There are two numbers in blood pressure, and they are written as

systolic over diastolic. The first value is the systolic pressure, which is the force of blood

pressure in the arteries when the heart beats. The second value is the diastolic pressure which is

force of the blood pressure in between heart beats. The units for blood pressure are millimeters

of mercury (mmHg). A normal resting blood pressure is considered to be less than 120/80. Blood

pressures much higher than this value indicate the possibility of hypertension and values much

lower than this value indicate possible hypotension.

Heart rate is the measurement of the rate of heart beats, in beats per minute. A normal

resting heart rate is 60-100 beats per minute. Oftentimes, well-trained individuals such as

athletes will have a lower resting heart rate. This is because the volume of exercise they do

strengthens the muscles of the heart, allowing their heart to do less work. On the other hand,

sedentary individuals may have higher resting heart rates because they are not as active, and their

heart has to work harder. Age, gender, and other factors such as physical activity may impact

heart rate.

It is important to test blood pressure because there are not typically any apparent signs or

symptoms of high blood pressure. If someone goes on without knowing they have hypertension,

serious heart issues may arise. We assess blood pressure both at rest and during exercise to

determine if an individual is at risk for any cardiovascular diseases, including stroke. Blood

pressure should increase with exercise since there is an increase in blood flow to get more

oxygen to the muscles. However, it should return to a “normal” resting blood pressure shortly
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after. If the blood pressure is significantly larger or smaller during exercise than the blood

pressure at rest, the individual is at risk for cardiovascular diseases. In the case that an individual

does show a drastic increase or decrease, it should be recommended that they see a doctor. We

must take at least two measurements of each to ensure that the blood pressure is being taken

accurately. If you depend on only one measurement and a mistake is made during the process,

you could mistake a person who has normal blood pressure as someone with hypertension. This

could be the difference in whether an individual is prescribed with blood pressure medication or

not. Additionally, factors such as caffeine consumption and physical activity before testing could

impact blood pressure. For the most accurate results, the client in a seated position should have

their feet flat on the ground and not crossed, and the arm being tested should be at heart level. It

is also important to assess heart rate both at rest and during exercise to determine if the

individual has a normal resting heart rate and if it increases to an appropriate or normal value

during exercise. You can use their resting heart rate as a baseline comparison to the heart rate

during exercise. It is normal for the heart rate to increase during exercise, but it should not

completely skyrocket. The resting heart rate and heart rate during exercise may also demonstrate

whether an individual is more sedentary or active.

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Data

One error I observed other classmates make when taking my blood pressure was that the

cuff was placed too high up on my arm. It felt like the cuff was squeezing the muscles of my

upper arm, rather than being over the brachial artery. This caused my systolic blood pressure for

that reading to be higher than all of the other readings. Another mistake I noticed was that some

of the administrators forgot to support my arm at heart level. Because my arm was lower than

heart level this could have led to a slight increase in both systolic and diastolic blood pressures.

Additionally, I observed that some of my classmates placed the stethoscope under the cuff which

could have caused them to hear more sounds than just the Korotkoff sounds of the blood

pressure. I did not observe any errors in classmates taking my heart rate. All of the administrators

properly palpated the site of my radial artery and seemed to determine accurate readings. Most of

them counted in 15 second intervals and found consistency between the administrator and the

observer. All of these errors could have led to slightly inaccurate readings, but overall, my

classmates were able to understand and fix their mistakes relatively easily.

I am fairly confident in the accuracy of my blood pressure and heart rate measurements.

All of my data was close to each other with the exception of one reading. This reading read that

my systolic blood pressure was 140, which I believe is a little high, but the errors stated above

could account for this difference. Besides this one data value, all of my measurements were

similar on the days they were taken. There was a relatively large difference between some of my

heart rate measurements, but these measurements were taken on different days. Some of the

explanation for this could have been other factors such as caffeine intake or physical activity

right before class. As a result, I believe that my classmates accurately tested my blood pressure

and heart rate.

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My heart rate and blood pressure responses to exercising on the bike versus being in a

seated position without exercise were similar. I would have expected both measurements to

increase during exercise, but they stayed around the same values. As you exercise, your muscles

need more oxygen, causing the heart to beat faster and the blood flow pressure to increase. With

these increases, the heart is able to get more oxygen to the heart. A normal resting blood pressure

is around 120/80 mmHg and a normal resting heart rate is between 60 and 100 beats per minute.

All of my measurements, both resting and with exercise stayed around these values. One error

that could account for the exercise measurements not increasing more is if the administrators did

not let me bike long enough. My muscles may not have needed extra oxygen yet, resulting in my

heart not having to work as hard and fast.

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Learning

I found it useful to read all of my peer observations. I would agree with all of the comments and

suggestions they provided me. Both myself and my observers agreed that I had appropriate client

interaction. There were two instances when my heart rate measurement was not accurate with the

observer’s heart rate measurement. I do not feel as though I measured incorrectly; it is possible that

measuring over a longer time period than 15 seconds could have allowed the heart rates to align with each

other better. The observer or I may have counted too fast, missed a few beats, or palpated the site too

forcefully, causing the difference in measurements. The only correction I received for blood pressure

measurement was making sure that the blood pressure cuff was over the artery. I believe I was relatively

consistent and accurate with the placement of the cuff, but I may have missed this error. Overall, the peer

observations were important to help me learn about a few errors I made. It was also useful to see that

most of my techniques were done properly.

One specific problem I had when testing clients was hearing the systolic blood pressure. This

could be corrected by ensuring proper placement of the cuff and stethoscope and having a quiet

environment. I also believe with more practice and time this error may be resolved and I will be more

comfortable with making this measurement. Another technique that was an issue for me was deflating the

cuff at an appropriate rate (2-4 mmHg per second). During my first few measurements I was inconsistent

and deflated the cuff too slow. As I got more practice I got better at deflating at an appropriate rate. I can

correct this problem by making sure that the valve is not too tight at the start of my test and I can use my

thumb and pointer finger to have better control over the deflation.

One of my most valuable learning experiences was practicing blood pressure measurements

during exercise. I found that it was easier to hear the sounds while the client was exercising. This allowed

me to learn what I should be hearing and gave me more confidence in my testing abilities. Another

experience that I valued was observing other classmates. I was able to learn from their proper techniques

as well as some of the errors they made. This entire lab was an important learning experience as it was

one of the first times I had practiced taking blood pressure measurements.