Vital Sign Question??

  1. our teacher posted this question on our msg board and i was curious as to what you all think the answer is...

    when would you take the pulse in relationship to bp and why??
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  2. 14 Comments

  3. by   StudentSandra
    as in which one would you do first?

    i'm not sure i understand what you are asking.
  4. by   Ortho_RN
    Sandra.. I guess that is how she meant it... I typed the question just like she did...
  5. by   Km41566
    I would say take the pulse first because taking the blood pressure could cause the pulse to rise because of the increased pressure applied to the arm while getting a reading. While getting your blood pressure taken is not painful, it can be a little uncomfortable at times. But I am only in my second semester of nursing courses, so my rationale may not be right!!
  6. by   StudentSandra
    originally posted by km41566
    i would say take the pulse first because taking the blood pressure could cause the pulse to rise because of the increased pressure applied to the arm while getting a reading. while getting your blood pressure taken is not painful, it can be a little uncomfortable at times. but i am only in my second semester of nursing courses, so my rationale may not be right!!

    that's pretty much the same thing i was thinking, if the question was why take the pulse first. the only other thing i could think of with my 2nd semester mind was that if the bp is low and the pulse rate high, it could indicate hypovolemia.
  7. by   nurseleigh
    We were never really told what order to do them in, but it was always listed as B/P, T,P,R. I just assumed that this would also be the order that they would be taken. Although it does seem smarter to take the pulse BEFORE the B/P now that i think about it. You are gonna have to let us know what the answer is, I am really curious now!!!!

    Traci
  8. by   KRVRN
    And if the question wasn't meant to be "what order should you take them in?" I offer this...

    Is it so you know how high to inflate the BP cuff?

    I remember learning that if you pump up the BP cuff while palpating the pulse distal to the cuff, then you have a vague idea as to what the systolic is. So, basically at whatever number you couldn't feel the pulse anymore, then that's what the systolic BP is (or the rule was to add 10 or 20 or something). Therefore you don't inflate a LOL's arm up to 250 and pinch it off when her systolic is only 100 (just inflate to 150 or so). Also, you won't have to worry that someone's SBP is actually higher than whatever you inflated the cuff to.

    So my answer would be to take the pulse first (so you know what it is), then inflate the cuff while palpating the pulse distally,
    then take the BP inflating the cuff only as far as necessary (after waiting the appropriate 1 or 5 or whatever minutes the rule is in between inflations).
  9. by   zacarias
    Hey all,

    I would always take the BP last of the vitals. I believe the teacher was asking what Sandra spoke of. The BP/pulse connection.
    For instance, when checking for orthostatic hypotension, you would take ones BP and pulse because if they are dizzy when getting up, we know that cardiac output has dropped and their BP is lowering. The heart then beats faster (increased pulse) to compensate. So measuring both BP and pulse can help one assess these situations. Generally if BP starts to fall, pulse goes up to compensate.


    Z
  10. by   shyviolet78
    I agree with KRVRN. Actually, I was taught to take pulse before BP for this reason of not over-inflating the BP cuff.
  11. by   Genista
    Maybe I'm wrong, but I don't think the instructor meant "when" as in what do you take 1st in a set of VS. I took the question to mean, "under what circumstance would you take a pulse & relate it to the BP & why."

    The answer is you ALWAYS take a pulse w/ a BP. The reason why is that VS are taken as a set every time. A pulse by itself or a BP by itself does not tell you anything, you must look at the big picture with a complete set of VS. BP & HR are interconnected. You need a full set of vs to see what's happening. Relate current VS to pt's dx & pt's baseline VS to help w/ your critical thinking. For example, hr= tachy, BP=high (why? pt w/ cardiac hx? hx htn? pt in pain? fluid vol. overload? etc), or hr tachy, bp=normotensive (is pt hypoxic? cardiac hx? what is dx?) or hr brady, bp brady (hypovolemia? syncopal? septic shock? what is dx?).

    I guess the answer depends on how we interpreted the question. ;-) Let us know what your teacher says. Good luck.

    ~kona
  12. by   Ortho_RN
    Hey all...

    Me and my classmate, who also comes on here... Both thought the answer was what KRVRN, had to say.... So I will let you know once the teacher posts the correct answer.. Thanks for all the input... Really gets ya thinking...
  13. by   BrandyBSN
    I was thinking more along the lines of when you suspect a shock state. If pulse is very fast, but BP is Low, that might be pointing to hypovolemia.

    Funny, how we can all read one question, and get different meanings from it

    BrandyBSN
  14. by   KRVRN
    When's your teacher gonna post the answer? I wanna know!

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Vital Sign Question??