THE KAREN MEDICAL TRAINING COLLEGE

TOPIC FUNDAMENTALS OF NURSING

SUB TOPIC:VITAL SIGNS

PRESENTER:J MUSONYE

VENUE:CLASS I

CLASS :APRIL 2016

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 Objectives
By the end of the lesson the learner will be able to :
Define blood pressure
List factors that affect blood pressure
Differentiate types of blood pressure
Identify sites for taking accurate blood pressure
States methods of measuring blood pressure
Describe steps in measuring blood pressure

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 Blood pressure(BP)

pressure exerted by the blood as it flows through the

arteries
Systolic pressure contraction of the ventricles
Diastolic pressure-pressure when the ventricles are at rest
Pluse pressure the difference between the systolic and
the diastolic
BP is measured in mmHg
Mean arteral pressure >60mmhg
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 Factors that determine blood
pressure
Pumping action of the heart
Peripheral vascular resistance
Blood volume
Blood viscosity

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 Pumping action of the heart

The lower the cardiac output the lower the blood pressure
I.E cardiac patients , hypovolemia

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 Peripheral vascular resistance

The internal diameter of the arterioles and the capillaries

determines the greater part the peripheral resistance to
the blood in the body.

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 Blood volume

Decreased blood volume - IE Dehydration and

haemorrhage

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 Blood viscosity

Blood pressure is higher when blood is highly viscous

(thick)

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Factors affecting blood pressure

Age pressure rises with age

Exercise
Stress-
Race African American to European Americans
Sex at puberty females have higher blood pressure same to
menopause
Medication
Obesity
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 Factors affecting blood pressure
Medical conditions-cardiac diseases that affect CO
Temperature fever cause vasodilatation, cold
-vasoconstriction

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 Hypertension
Blood pressure is persistently above normal
Asymptomatic
Major cause of myocardial infarction (stroke)
Primary hypertension-unknown cause
Secondary hypertension known cause

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 Hypotension
BP that is below normal
Causes
Can be due to drug use sedatives ,antihypertensive
Hypovolemia /dehydration

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Equipment for measuring BP
Sphygmomanometer
Stethoscope
Appropriate cuff size

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 Sites for blood pressure
Upper arm brachial artery
Or any other limb due the following:
Arteriovenous fistula
Intravenous infusion
Blood transfusion
Mastectomy
Fracture /cast
Amputation of the limb
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 Methods of measuring blood
pressure
Direct invasive insertion of catheter in the brachial,
femoral radial arteries (arterial line )more accurate
Indirect -non invasive using the
cuff,stethoscope,sphygmomanometer
Palpatory

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 ARTERIAL BP

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Steps of measuring blood pressure

Position the client supine or sitting

Arm should be at the heart level-BP decreases when below
the heart level
Expose the arm
Locate the brachial artery apply the bladder directly over
the artery an inch above antecubital space
Inflate the cuff
Position the stethoscope appropriately
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 Steps of measuring blood
pressure
Auscultate the clients blood pressure
Release the cuff slowly at 2-3mmHg /sec while listening to
identify the 5 phases of korotkoff sounds and the levels
at which they appear
Remove the cuff from the clients hand
Inform the patient of his blood pressure

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 Steps of measuring blood
pressure
Wipe the cuff with appropriate disinfectant
Document and report
Electronic cuff can be left in place for up to 4hours the
alternate sites
Clean the cuff every 24hours

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 Measuring blood pressure CT
Infants
use the correct cuff
Bp 50-90/25-55mmHg is normal for new-born
Children
-1yr-3yrs
Congenital heart diseases, renal malformation, medication that affects BP
ELDERLY-
medication for BP find out the time they took the medicine
Contractures can use palpatory techniques
Dont keep the cuff on their hand for longer time
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 Electonic BP MACHINE

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 Summary
Define blood pressure
Factors that determines blood pressure
State factors that determine blood pressure
Distinguish between hypertension, hypotension and
orthostatic pressure
Identify sites for measuring accurate blood pressure
Steps of blood pressure measuring
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 Evaluation
When should you check blood pressure for a patient
What are the factors affecting blood pressure
Distinguish between primary and secondary hypertension

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 References
Kozier&Erbs.(2012)Fundamentals of Nursing(8th
ed).Pearson. Pages 535-567.

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 ANY

QUESTIONS

THANKS

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