The only skill I don't understand is BLOOD PRESSURE!

Scarlettz, BSN, RN · Jun 18, 2012

I never thought blood pressure was going to be such a challenge! But it worried me sick my first couple of semesters. As mentioned, make sure that you have a properly working stethoscope. And as silly as this may seem, make sure you have it on the right way. Tap the diaphram and make sure you hear a clear tap. Other ideas:

-Buy a sphygomometer at Life Uniform or online to practice with at home. Practice applying it with ease and make sure the tubes aren't banging about when you are trying to listen.

-Make sure that your patient is not talking and moving about.

-Make sure that you apply the right size cuff.

-Make sure you follow proper technique so that you pump up the cuff high enough to hear both sounds.

-Make sure that the diaphram doesn't move about when you are taking the reading.

-Make sure you are not releasing the valve too fast.

-If it helps, shut the curtains or door to help eliminate extraneous noise.

-Go in and practice with an instructor. I did this and they offered good advice and were very patient.

-It gets easier with practice. I had to do like 15 or so blood pressure readings during a community event. It really helped me to get comfortable with the skill.

IV tubing and piggy backs are my concerns now. I guess actually hanging them is not so bad, but I think the pump and tubes can just seem intimidating.

DroogieRN · Jun 18, 2012

Besides a good stethoscope, make sure you palpate the brachial pulse first and place the diaphragm over that. Sometimes it's not where you think it should be...

GitanoRN, BSN, MSN, RN · Jun 22, 2012

it's the only skill i can not perform properly. i have tried so many times and failed to the point were i'm honestly considering that maybe i am partially deaf. i seriously can not hear the heart beat!! however, all my classmates can and some even got it on the first try. i had a friend with no healthcare experience try it and she also got it on the first try. what is wrong with me??? why can't i hear anything?!
can someone please tell me some tricks to obtaining the blood pressure? otherwise, i just hope and pray i don't get blood pressure on the state exam. i never thought blood pressure would be so hard.
also, as a side question, are there any skills you all personally had a hard time with?

in addition, to all the good advise that you have received i wanted to share with you this link that i found purely accidentally and it reminded me of you. having said that, it offers you the chance to listen to several bp's regarding multiple pt. scenarios with h/p information follow by auscultation, and diagnosis. give it a try and see if i it helps...once again i wish you the very best always....aloha~

http://www.practicalclinicalskills.com/blood-pressure-lesson-chart.aspx?coursecaseorder=1&courseid=102

IEDave, ASN, CNA, LVN · Jun 24, 2012

in addition, to all the good advise that you have received i wanted to share with you this link that i found purely accidentally and it reminded me of you. having said that, it offers you the chance to listen to several bp's regarding multiple pt. scenarios with h/p information follow by auscultation, and diagnosis. give it a try and see if i it helps...once again i wish you the very best always....aloha~
http://www.practicalclinicalskills.com/blood-pressure-lesson-chart.aspx?coursecaseorder=1&courseid=102

sweet! gracias! :bow:

incidentally, in my cna class there were a couple of people that were employed as techs in area hospitals that failed their skills test because they couldn't get accurate bp results. it's a skill that does take some practice to get proficient at so try not to get too discouraged.

----- dave

minnymi · Jun 24, 2012

Ditto to the above suggestions. Also make sure the stethoscope is set to the diaphragm part and not the bell (by twisting the tubing and testing the sound).

he/she is correct! i remember when i realized there was a way to turn the 'sound' on/off on a stethoscope.

i always had a hard time too because i have "will smith" ears. i don't have big ears....i have really SMALL ears...and they stick out a little bit! i could only put the stethoscope in my ears for a few seconds before it HURT. i'm not a wimp, but it was nearly unbearable pain! i can't wear earpieces for phones, mp3 players....none of them will even go in my ears. they just fall right out.

anyhow, it also had to be QUIET for me to hear (and still does). it's rare that i actually have to do a manual BP now, but when i do...i will shut the door, ask people to leave the room if need be, and turn the TV off.

Bobmo88 · Jun 25, 2012

I don't thing anyone else mentioned this but also make sure that the ear pieces are in the correct way! As a volunteer, I was observing a nurse put in an NG tube and I had my stethoscope with me and she forgot hers so she wanted me to listen to confirm placement by listening to the stomach for air that she (for lack of a better term) "squirted" in via syringe. I couldn't hear a thing and then she realized that I had the earpieces in the wrong way. Ever since then I never forgot the right way to wear a stethoscope! Littmann Stethoscope Use - How to Use a Stethoscope : 3M Littmann Stethoscopes: 3M US I don't know where are you placing the stethoscope when you take a blood pressure but make sure you are palpating for the brachial artery in the antecubital area and placing the stethoscope directly on it before you pump up the cuff. If that isn't the problem, I would try a higher quality stethoscope and maybe changing out the rubber ear pieces. If not, then I would recommend a hearing test. Good luck!

nguyency77, CNA · Jun 25, 2012

Turn the earpieces of the stethoscope forward. They shouldn't be backwards in your ears, pointing to the back of the neck! When I was taking my CNA class, some of the people who couldn't hear the heartbeat just had the earpieces pointed the wrong way. Good luck!