I've got a question about BP - page 2

Hello All, I am a nursing student and I have a question about BP. I am confused as to when the diastole start. I will pump it up to 130 or so (depending on radius pulse) and then let it out... Read More

  1. by   LilPeanut
    In school they taught us to find the palp first to know exactly how high to pump the cuff.

    You put the cuff on, feel the radial pulse with your finger, then pump up the cuff. When the pulse disappears, you add 10-20 to that and that's how far you pump it up
  2. by   KellNY
    Quote from LilPeanut
    In school they taught us to find the palp first to know exactly how high to pump the cuff.

    You put the cuff on, feel the radial pulse with your finger, then pump up the cuff. When the pulse disappears, you add 10-20 to that and that's how far you pump it up
    Seems a bit redundant to me. And maybe I'm misunderstanding you, but...how do you know how high to first pump the cuff when you palpate? Because if you know how high to pump it that time...why not just do it while auscultating and get it done in half the time with half the discomfort?
  3. by   LilPeanut
    It is redundant, that's why most people don't do it, but it is technically the proper way to find the systolic, according to my instructors.

    And you are just feeling the pulse the whole time you inflate the cuff, so you can feel the pulse fade/stop, so you know when to stop.

    www.steeles.com/catalog/takingBP.html Here's a page that explains it
    Last edit by LilPeanut on Mar 24, '07 : Reason: edited to add link
  4. by   maryloufu
    You know what OP? God bless you for asking questions and getting it all straight in your head- I know of students who are either too afraid to ask or don't care- and that is scary- I don't need my co nurse to make up a number for me- and those automatic ones are wrong as much as they are right. So keep asking questions- you are going to be a good nurse.
  5. by   KellNY
    Amen and good point mary!

    When i taught medical assisting, I can't tell you how many students would just say "Yep. It's 126/82" I'd go check and get a way diff number, so we'd use the steth with 2 sets of ear buds (OP, have you tried that so you can compare notes with classmates and instructor?) and asked what she got. I'd get a stammering "Uh, I, um...like 128 over 78?" when really it was 104/62 or 142/88, etc.

    Very scary, because I also can't tell you (and I'm sure any experienced member can concur here!) how many routine vitals picked up a very abnormal BP for the 1st time.
  6. by   shoegalRN
    Quote from maryloufu
    You know what OP? God bless you for asking questions and getting it all straight in your head- I know of students who are either too afraid to ask or don't care- and that is scary- I don't need my co nurse to make up a number for me- and those automatic ones are wrong as much as they are right. So keep asking questions- you are going to be a good nurse.

    Thank you MaryLou! I'm usually the one asking questions about 1000 times in clinical lab. I did have my instructor listen to my lab partner's BP with me to make sure I was reading it correctly, but she went through it so fast, I just got lost. Since that lab, I had be practicing on just about anyone I could get me hands on and I always heard the sound, but was confusing systolic with diastolic and was not calculating correctly. Also, someone else mention to palpate the radius pulse until it goes away and add 10-20 more to it when puffing the cuff and that's exactly what my instructor told us to do also. So, the number 130 I mentioned before came from my lab partner. For some reason, I was using 130 on everyone I practiced on.

    What I'm gonna do it try puffing it up to 160 or so and also try the radius pulse thing and add 10-20 more to it and see what I come out with each time.

    I'm really grateful for this site, so informational!
  7. by   hellonurse36
    Here is a simple explanation (sounds like you have it all figured out now, but thought I'd add my 2 cents).

    To help you understand what is the systolic vs diastolic it helps to know how a BP cuff works and understand WHAT you are hearing and WHY you are hearing it. As you inflate the cuff you are exerting pressure against the artery, the number the needle points to indicates the pressure being applied. When you inflate the BP cuff beyond the pt's systolic (highest pressure in arteries - occurs during systole or when the heart is contracting) it occludes blood flow and you do not hear a pulse. You slowly let the air out and once the pressure of the cuff EQUALS the systolic pressure, blood flow is no longer occluded and it rushes past your stethoscope, hence you hear the sound. The number on the gauge at this point is your systolic or top number. As you continue to let air out of the cuff, eventually the pressure in the cuff will be lower than the pressure in the artery during diastole (when the heart is at rest) and you won't be able to hear the blood flowing by....this is your diastolic or bottom number.

    I think most nursing students have problems learning how to take a manual pressure. Keep practising - it's the only way you really get confident.

    Terri
  8. by   kukukajoo
    Nurse2B- 160 will be too high for some- on my grandmother it would be very painful. Try to do it the way you were taught and people on here have suggested as that is the proper procedure- feel for the radial pulse, then begin pumping the cuff. Once the radial pulse stops, pump up another 15 mm hg. At that point you release it and listen closely for the pulse to to begin again (systole) and then when it stops, that is the diastole.

    Don't worry, you will get it I promise. Also, somewhere on here is a link to a site that is a virtual BP site- I used it a lot to understand and it helped me. I also practiced on everyone who came over my house until they were sick of me!
  9. by   natrgrrl
    It sounds like you know what you are doing now but I found one website to help. I'm sure there are many others.
    http://www.phschool.com/science/biol...0/measpr3.html
  10. by   shoegalRN
    I would like to thank everyone who have responded. It has really clarified things for me and have helped me a great deal. I really do apperciate the links, they are really helpful!
  11. by   TazziRN
    Quote from LilPeanut
    It is redundant, that's why most people don't do it, but it is technically the proper way to find the systolic, according to my instructors.

    And you are just feeling the pulse the whole time you inflate the cuff, so you can feel the pulse fade/stop, so you know when to stop.

    www.steeles.com/catalog/takingBP.html Here's a page that explains it
    I've been an RN for nearly 19 years and was a CNA for 4-5 years before that. This is the first time I have ever heard of this as the proper way to take a BP.

close