Positions of taking blood pressure in PIH patients

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    I am curious what position do you p ut your moms in when taking their blood pressure expecially in PIH patients and your rational behind it. Sitting up or lying down on their left side?
  2. 6 Comments so far...

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    I would say take it with the patient laying down because sitting up make cause a rise in BP?
    Quote from mugwump
    I am curious what position do you p ut your moms in when taking their blood pressure expecially in PIH patients and your rational behind it. Sitting up or lying down on their left side?
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    Not that I know much yet as a student, but I am doing a presentation on PIH tomorrow for school and my books said (for preeclampsia) to use 2 readings taken 6 hrs apart while on bed rest. If it's in the office you probably couldn't do that of course but I'd think you'd want to have them as calm as possible so the reading wouldn't be skewed because of whitecoat HTN, exertion, or whatever.
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    Quote from mugwump
    I am curious what position do you p ut your moms in when taking their blood pressure expecially in PIH patients and your rational behind it. Sitting up or lying down on their left side?

    If you are just trying to figure out if a person has PIH you should just make sure that they are all taken in the same position. If there is a rise in that position you can check postural changes to see if maybe bedrest will solve their problem or if they need medís.

    If you are evaluating someone with known PIH you should take it in the position that they are in most. So if you have a person that is walking around you would want to take it standing or sitting and not long after they had been walking. If you have a bedrest patient itís okay to take it while they are lying down.

    If your bedrest patient has a high pressure while lying down, recheck it, consider factors that might be temporarily raising it, eliminate them, take it again. If itís still high call the doc for meds if itís lower you can just work on the factors that raise it. If your patient that is walking around has a high pressure, maybe they need to be on bedrest.

    I had some trouble with a patient (who was also a nurse). She would run around all day even though she was inpatient for bedrest. When I went to take her pressure she insisted that I wait 15 min for her to lye down on her left side before letting me take the BP.

    We compromised and took it while she was sitting but didnít wait the 15-min. We had a talk and she became more compliant with her bedrest because her pressure was running really high when we took it my way although it had been looking good when done her way.

    It allowed me to show her why she needed to be more compliant with her bedrest (which of course she already knew but was fooling herself).
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    Quote from mugwump
    I am curious what position do you p ut your moms in when taking their blood pressure expecially in PIH patients and your rational behind it. Sitting up or lying down on their left side?
    Your patient has had her BP checked in the office while sitting. This is the standard. Once they are dx'd with PIH, bedrest in a lateral position is treatment, so you should use the same arm and the same position each time. When I admit a patient to the hospital, we do BP in both arms sitting, then in a lateral position. After that the BP is recorded in the same arm and the same position. It is comforting for moms to see that their BP is lower when they are at rest.
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    in normal pts, I just take it when they're sitting in the bed. If it's elevated, I will tilt them off their back and retake it. If it's better when they are off their back, I'll just let the physician know, hey, the BP was this on her back, on her side it was this.

    For PIH pts, I'll usually just take it however she happens to be lying. I had a PIH induction the other night and the MD said to call if it's above a certain number on her side.
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    Quote from mugwump
    I am curious what position do you p ut your moms in when taking their blood pressure expecially in PIH patients and your rational behind it. Sitting up or lying down on their left side?
    We just reviewed this for our annual competencies at OB education day today at work.

    You should be taking EVERY patients blood pressure with them sitting up. This puts the arm at the level of the heart, which is the "normal" blood pressure for a pregnant patient. If it's elevated, then the physician/midwife can look into whether it's PES (preeclampsia syndrome) or not.

    When you take the woman's blood pressure with her lying on her side, the arm is on top of her, above her heart, so it will DEFINITELY be lower than when she is sitting upright.

    The above information was also found in nursing research articles (will have to find the exact source of the article when I go back to work tomorrow).

    Jen


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