Taking patient's blood pressure

  1. I'm a CNA and I have a question to ask of those more experienced than I in taking a blood pressure.
    I am finding that I am having more trouble "hearing" the diastolic and systolic readings. Is it possible that my slight hearing deficit could make it difficult for me to accurately take a blood pressure? This may be a 'no brainer' but I need to be accurate in task.
    Any thoughts are greatly appreciated.
    Lin
    Hospice CNA
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  2. 19 Comments

  3. by   antidote
    You have NO idea how hard is was for me to hear the sounds. I would always be like, huh? Did I hear the who make the what noise? Trust me, you'll get it.

    Here are a few personal tips:
    • The stethoscope means a LOT to BP readings. Is it of higher quality? Perhaps you require an amplified one if you're hard of hearing? Can you hear heart sounds okay? Is the placement of the stethoscope correct? Personally, I use a Littmann II Cardiology. I spent $297 on that puppy and it's great clear sound;
    • In addition to the above tip, you do pay for what you get! (trust me!)
    • If you need to take it more than once, DON'T BE EMBARESSED. Just say "Well, gosh darnet I think I missed the last sound! Let's try it on that other arm!". Also as an aid/tech, the nurses should always be willing to do this for you if you need help. Just right down what you believe the BP reading is, give it to the LPN/RN and explain that you had trouble -- he/she should be able to take it for you. No biggie!
    In the mean time, check out:

    http://www.steeles.com/catalog/takingBP.html

    http://deptets.fvtc.edu/nursing/index.htm (Lesson #51)

    Great quickie resource I pulled up! If you have any questions, feel free to ask me personally.

    Good luck!
  4. by   mcknis
    Never be afraid of admitting you did or didn't hear something. their have been many times where I think a BP is too low or high and want an extra reassurance from one of the nurses, only to find out that I was correct in the first place. But, it is always better to be safe than sorry. They trust you even if their license falls back on the line.
  5. by   Ginny Weasley
    OMG. I had such a hard time learning how to hear the sounds. X__x It was awful. You have to work really hard on tuning everything out. If not, it might be your stethoscope. I've dropped mine on the floor several times, but it still works great ^_^;
  6. by   nasaodds
    I have just come upon your response to taking blood pressure. I took my state cert. test a few weeks ago and passed written and 4 0f 5 skills the 0ne skill was vitals that I FAILED. That is how the word appeared to me on my results. The main reason for not getting it was not enough practice throught my CNA course and the clinicals that I recieved. Nerves got the best of me and that is not like me. It is nice to hear that other people have some difficulty with this. I will check out the web sites.
    Thanks,
    Erin
    Ky
  7. by   Gabby_101
    The only other thing I can think of is when you are letting the air out of the cuff go really slowly so you can try to hear better and you will hear one definate number for the blood pressure.
  8. by   jmgrn65
    Are you making sure to palpate the pulse before you inflate the cuff? Then place the stethoscope there, then when deflating do so very slowly and try to make sure no one is talking.
  9. by   Miami NightNurse
    Quote from jmgrn65
    Are you making sure to palpate the pulse before you inflate the cuff? Then place the stethoscope there, then when deflating do so very slowly and try to make sure no one is talking.
    Do the above and if you still can't hear well get a better stethoscope. I am Hard of hearing so I have Littman 3000- it's a electronic stethoscope that amplifies the sound. They are not cheap, they cost about $280.00 but I figure if I can pay $30,000 for a car, I can put some $$$ into what I do every day and this stethoscope is well worth it. Most Medical Supply stores & uniform stores don't sell them, you have to buy them on line. I just looked they are $257 at this site: http://www.steeles.com/catalog/3000_stethoscope.html
    Last edit by Miami NightNurse on Mar 15, '08
  10. by   JaredCNA
    I'd have to say the hardest part of my CNA class was hearing the sounds when taking a blood pressure. And, it was HARD! My mom and aunt (both nurses) as well as the instructor kept telling me when I heard it, I would know. I was like, what the hell does that mean? They kept saying, once you hear it for the first team, you'll usually be able to catch it every time from then on. It was very frustrating.

    But one night, after taking my wife's B/P for the 100th time, I finally heard it. I'd also agree that it really depends upon the quality of the stethoscope.

    Good luck.
  11. by   achieve08
    I feel the same way the OP does. I'm pretty apprehensive about the state test - I've never actually gotten to take a BP myself - only listened/watched videos in class. I can't afford to buy the cuff for myself, either.
  12. by   jaywolves
    I just started class last Saturday we began practicing this skill immediately after the lunch break (8 hour class for 11 weeks) and it became obvious immediately that I was going to need more practice in this. It's not as easy as you think it should be and the brachial pulse does not the make the noise you think it's going to.

    I know I expected to hear more of what one would hear with the steth on their chest listening to heart sounds. This is SUCH a more subtle sound. I went out after class and bought a Littman Clinical - on the cheaper end of the Littman spectrum, but still far better than the ultra cheap Prestige models we were using in class.

    I've practiced on my wife all week. Taking all of her vitals and reporting objectively and subjectively with whatever she will tell me doesn't feel right for the day. I've kinda lucked out this week and it sounds sick to say, but she's had the flu for the last two days. Watching how much her vitals actually changed, the shallow and accelerated respirations, elevated blood pressure, elevated pulse, high temperature, have really helped drive home some of these skills.

    I wouldn't suggest getting your loved one's sick so you can "play nurse" at home, but... it definitely helped me figure this out. I'd still like to have someone else take her blood pressure so I can compare what I'm coming up with.
  13. by   aundrea543
    Quote from Linj
    I'm a CNA and I have a question to ask of those more experienced than I in taking a blood pressure.
    I am finding that I am having more trouble "hearing" the diastolic and systolic readings. Is it possible that my slight hearing deficit could make it difficult for me to accurately take a blood pressure? This may be a 'no brainer' but I need to be accurate in task.
    Any thoughts are greatly appreciated.
    Lin
    Hospice CNA
    I want to say thanks for starting this thread. It's nice to know I'm not the only person to struggle with this. My CNA classes will be starting in a couple of weeks and I'm getting really nervous. My bf completed EMT Basic last fall and so to rest my nerves a little he got me started on taking Blood Pressures. I stink at it. I have an okay stethoscope. I can hear heartbeats fine and can hear great when I take my boyfriend's BP (he has high blood pressure avg. 160/90), but when I tried to get it on other people ( about 3 different people) I couldn't hear it at all, or at least not enough to get an accurate reading. I was wondering if his high blood pressure is what made it easier for me to hear him, or perhaps it was just my comfort level... let's just say I definately need the practice, and I'm glad I started early.
  14. by   jaywolves
    One thing that helped me was to lay in bed and with the same fingers I take pulse, I found my brachial pulse. That took awhile. In class we were not told to take it anywhere but the crease of the elbow. So once I found my brachial pulse, I started placing my stethoscope in about the same spot on all of my practice partners in class. Made all the difference in the world. I went from never being able to for sure hear it to being able to tell what was going on. I found for most - it is easier to hear way on the inside of the arm about almost under the bicept.

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