Guidelines for Measuring

Blood Pressure

HST Class
 Do not take blood pressure on an
arm with an IV infusion, a cast, or
a dialysis access site.
 If a person had breast surgery,
blood pressure is not taken on
that side.
 Also avoid taking blood pressure
on an injured arm.
 Ifthe patient has been exercising
or walking around, or has just
received a treatment, let them
rest for 10 to 20 minutes before
measuring the blood pressure.
 Measure blood pressure with the
person sitting or lying.
 Use the correct size blood
pressure cuff. For example, a
pediatric cuff for a very small
arm, a Large or Extra Large cuff
for patients with large arms.
 Apply the cuff to the bare upper
arm when possible. Do not apply
the cuff over thick clothing.
 Make sure the cuff is snug. Loose
cuffs can cause inaccurate
readings.
 Place the diaphragm of the
stethoscope firmly over the
brachial artery. The entire
diaphragm must have contact
with the skin.
 Make sure the room is quiet.
Talking, television, radio, and
sounds from the hallway can
affect an accurate measurement.
 Have the sphygmomanometer
clearly visible. Change your
position if you have to in order to
see it clearly.
 Measure the systolic and diastolic
pressures.
 Again, the first sound you hear is
the systolic pressure.
 The point at which the sound
disappears is the diastolic
pressure.
 Take the blood pressure again if
you are not sure of an accurate
measurement.
 Wait 30 to 60 seconds before
taking the blood pressure
readings again.
 Notify the nurse immediately is
you cannot hear the blood
pressure.
Factors Affecting Blood Pressure

 Age – blood pressure increases as

a person grows older. It is lowest
in infancy and childhood and
highest in adulthood. Blood
pressure usually continues to
increase with age.
 Gender – women usually have
lower blood pressure than men.
Blood pressures rise in women
after menopause.
 Blood volume – is the amount of
blood in the system. Severe
bleeding lowers the blood volume.
Therefore, the blood pressure
lowers.
 The rapid administration of IV
fluids increases the blood volume.
The blood pressure rises.
 Stress – includes anxiety, fear,
and emotions. Heart rate and
blood pressure increase as part of
the body’s response to stress.
 Pain – generally increases blood
pressure. However, severe pain
can cause shock. Blood pressure
is seriously low in the state of
shock.
 Exercise – increases heart rate
and blood pressure. Blood
pressure is not measured right
after exercise.
 Weight – blood pressure is higher
in overweight persons. The blood
pressure lowers with weight loss.
 Race – black persons generally
have higher blood pressures than
white persons do.
 Diet – a high sodium diet
increases the amount of water in
the body. The extra fluid volume
increases blood pressure.
 Drugs – can be given to raise or
lower blood pressure. Other
drugs have the side effects of
high or low blood pressure.
 Position– blood pressure is
generally lower when lying down
and higher in the standing
person. Sudden changes in
position can cause sudden
changes in blood pressure; this is
called “orthostatic hypotension.”
A person who stands suddenly
may have a sudden drop in blood
pressure. Dizziness and fainting
can occur.
 Smoking – increases blood
pressure. Nicotine in cigarettes
causes blood vessels to narrow or
“constrict”. With smoking, the
 heart must work harder to pump
blood through narrowed vessels,
so the blood pressure increases.
 Alcohol – excessive alcohol intake
can raise blood pressure.