I've got a question about BP

Nurses General Nursing

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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 slowly. I can hear it just fine, but don't know when I should start counting for diastole. I know the systole count is when you no longer hear the pulse, but do I start counting diastole right before the systole? Or do I start counting as soon as I hear the pulse? I'm confused and I'm scared if I don't get this together, I will record the wrong BP on a patient and that could result in death in some cases. PLEASE HELP!!!

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Unless I've been doing this wrong....(which is possible I guess)

The FIRST beat you hear on the way down (say around 120) is your systolic...the "top" number, the LAST beat you hear (say around 80) is your diastolic...so your bp is systolic/diastolic or about 120/80. I hope this helps

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
Unless I've been doing this wrong....(which is possible I guess)

The FIRST beat you hear on the way down (say around 120) is your systolic...the "top" number, the LAST beat you hear (say around 80) is your diastolic...so your bp is systolic/diastolic or about 120/80. I hope this helps

You are correct, AirforceRN2b.

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Ok, I mis-worded it. So, when do I start counting for systole? Is it when I hear the first beat? Or do I count the last beat right before diastole? BTW I'm a first semester nursing student, no previous nursing experience.

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Specializes in NICU.

systolic - first beat

diastolic - last beat

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

You pump up the cuff, then slowly let the air out while listening. There shouldn't be any pulse at first. If there is, you need to pump it up higher. The first sound you hear is the systolic BP. Keep listening, and when there is no further sound, that is the diastolic BP....the last beat you hear.

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Specializes in Nursing Professional Development.

Also, be sure you have pumped it up high enough to begin with. As tnbutterfly said, if you hear beats right away, then you did not pump it up high enough. You wrote that you pump it up to around 130. Many, many adults have systolic pressures higher than 130. You should be pumping it up at least 10 or 20 points higher than you expect the reading to be -- or even a bit higher to be sure.

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Ok, got it. Now another question. Let's say after you hear the first systolic beat do you count that number it falls on after the first beat as the systolic number? For example, after you pump it up to 140 or so and you hear the beat and it starts out on 120, then goes down a notch and then another notch, then finally silence, do you count the 120 as the systolic beat since it was the first beat?

I guess I'm confused because of the other beats until diastole.

So, if I'm understanding this correctly, the very first beat after letting out the air slowly is the systolic number? So, I shouldnt worry about the other beats after the first beat until diastolic? If that makes sense?

Thanks to all who have helped! I really need it!

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And make sure you have the right sized cuff, or your reading will be incorrect.

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

So, if I'm understanding this correctly, the very first beat after letting out the air slowly is the systolic number? So, I shouldnt worry about the other beats after the first beat until diastolic? If that makes sense?

Thanks to all who have helped! I really need it!

That's correct. The first sound you hear is the systolic number. Don't worry about the other sounds. Sometimes, on an older person the beats will be irregular. You need to listen carefully for the very last beat. And that last sound is the diastolic number.

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Specializes in High Risk In Patient OB/GYN.

Yep-1st beat is systolic, last is diastolic. Doesn't matter if there are 2 or 20 beats in between.

And 130 on an adult (unless you are familiar with that particular pt and know he/she runs low) is not adequate. I go up to 160 or so if they have no hx of hypertension....higher if it's not uncomfortable for them. No matter how high you decide to go-if you hear your 1st beat (systolic) right away or very shortly after releasing pressure--close the valve an pump it up another 20 or more, because it's likely higher than you've assumed (or hoped, lol).

If you only go up to 130 on your patients, no one will ever demonstrate a high reading as it would be impossible. Think of it like this--taking a temp with a thermometer that only goes up to 99.0. You'd never record a fever, whether your pt is 99.0 or is really 104.5. Very inaccurate, and potentially VERY dangerous.

Does that make sense?

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Yep-1st beat is systolic, last is diastolic. Doesn't matter if there are 2 or 20 beats in between.

And 130 on an adult (unless you are familiar with that particular pt and know he/she runs low) is not adequate. I go up to 160 or so if they have no hx of hypertension....higher if it's not uncomfortable for them. No matter how high you decide to go-if you hear your 1st beat (systolic) right away or very shortly after releasing pressure--close the valve an pump it up another 20 or more, because it's likely higher than you've assumed (or hoped, lol).

If you only go up to 130 on your patients, no one will ever demonstrate a high reading as it would be impossible. Think of it like this--taking a temp with a thermometer that only goes up to 99.0. You'd never record a fever, whether your pt is 99.0 or is really 104.5. Very inaccurate, and potentially VERY dangerous.

Does that make sense?

Yes, Kelly, that makes perfect sense! I think my problem has been not pumping it up higher, but since I know that now, I will keep that in mind. That may have been my problem all along.

Thanks so much for your reply!

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