taking bp,, had any luck doing it like this?

[northmississippi]

I've tried asking the pt what their blood pressure normally runs, but noone ever tells me right and its usually alot higher than they tell me.. have you run into this? I ask them so that maybe I can really be listening for the first sounds... Having gotten alot different numbers than what the pt tells me makes me think i'm not doing it right and hurts confidence.

[akulahawkRN, ADN, RN, EMT-P]

Don't ask them. Just do the measurement and then after you've gotten the data, ask them what their norm is. When you do it the way you've described, you can really set off "white coat syndrome" where a patient gets very anxious about things and that alone can increase all their vital signs well above normal for no other reason than a healthcare provider is in the room.

When you're taking a manual BP, palpate the brachial pulse right at the AC fossa (just medial to the biceps tendon) with the elbow extended. It should be VERY obvious. Put the BP cuff on and then put the stethoscope head right over where you felt the pulse. Start inflating the cuff and as you go above the diastolic number you'll start hearing the sounds. Keep inflating until you're about 20 mmHg above the last sound you heard and then start slowly letting the air out. The first sound you hear is the systolic number, and the last sound you hear is the diastolic number. Measure ONLY during cuff deflation, not inflation. I only reason I suggest listening during inflation is to ensure you're listening at the right place. As you get really good, you just palpate, put the cuff on, feel for disappearance of a radial pulse, inflate a bit higher than that, and start listening as you deflate. With practice this only takes about a minute or so, max.

[loriangel14, RN]

Not a good idea. You need to be doing your own assessment, not relying on what the patient tells you. You need to listen regardless of what they say.

[akulahawkRN, ADN, RN, EMT-P]

Not a good idea. You need to be doing your own assessment, not relying on what the patient tells you. You need to listen regardless of what they say.

I couldn't agree more, actually.

To the OP: Patients will lie, minimize, or otherwise tell you what they think is normal for them. Sometimes they're right, but more often than not, they're not. That's not to say that our patients are "bad" but they have their own issues to work with and through. So you do what you do and make no bones, judgments, or any fuss about what you're doing. Your job when taking a BP is to simply take the BP. It's just part of your daily duties when taking care of the patient so if you make it no big deal, the patient will usually feel the same way about it, and all's good.

[loriangel14, RN]

I had a patient tell me the other day his normal BP was 70/140. Thanks. That helps.

[TiffyRN, BSN, PhD]

It can be a lot like asking some people's weight. They mean the lowest weight they've had in the last few years. . .

First thing in the morning,

Naked,

After they voided,

Maybe with a fresh haircut!

But you get the idea.