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Measuring blood pressure, Part II

LTC Nursing Assistant Trainer, September 9, 2004

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An estimated one out of six people in North America suffers from high blood pressure, also called hypertension. Risk factors include stress, a family history of hypertension, obesity, salt consumption, alcohol consumption, lack of exercise, and smoking. High blood pressure is more severe--and about 50% more common--in African-Americans than in Caucasians. Last week's LTC Nursing Assistant Trainer included Part I of the general steps to follow in taking a resident's blood pressure. Part II completes these general steps as the CNA is preparing to inflate the cuff. They are as follows:  Close valve of air pump in a clockwise direction with thumb and index finger.  Inflate cuff by squeezing bulb until indicator is at least 20 millimeters above expected pulse sound.  Open valve counterclockwise slowly, letting air out gradually and watching gauge carefully.  Mentally note the reading on the gauge when the first clear sound is heard  Continue to release air slowly.  Mentally note the reading on the gauge at the sound of the last thump before the silence. Occasionally, especially in the elderly and children, sound can be heard even when the cuff is full deflated. If this occurs, retake the blood pressure and note when the sound changes to a softer sound.  Open valve all the way to release remaining air from cuff  Record blood pressure reading. If you are unsure of either the systolic or diastolic reading, wait one or two minutes before retaking. If the cuff is immediately pumped up again, the reading will be inaccurate.  Remove cuff from resident's arm and readjust clothing.  Make resident comfortable.  Wash hands, clean earpieces, return equipment to proper place, and leave the area neat and clean. High blood pressure is generally defined as a systolic pressure greater than 140 and a diastolic pressure greater than 90. Although normal blood pressure for adults is 120/80, a slightly higher or lower reading may be normal for a particular individual. Report immediately any systolic reading above 200 or below 95 or a diastolic reading above 100 to your supervisor. Healthy changes in lifestyle and antihypertensive medication can prevent blood pressure from rising to unhealthy levels.

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