Nurses General Nursing


I need some help, please. I have recently returned to working with real clients after years behind a desk. I love my job, but I am the only nurse working with a group of LSWs, so I have no peer to problem solve with. I am responsible for monitoring the v.s. for a group of elderly clients in an assisted living situation. I am confused when I take the Bps, and I see the needle jump far before I hear the first bump sound. Should I record the systolic reading from this very definite movement of the needle or from the first sound?? I have been unable to get a straight answer to this, and I want to recoed these readings accurately. Thanks for any help!!

My two cents or how I was taught to do it was taking the reading from when you first hear the sound until you can't hear it, regardless if the needle jumps or not. So that's how I do it.

I agree. With the first sound you hear, it is the turbulence of the arterial blood getting through the constricted vessel and the last sound you hear will be before the vessel is at a normal diameter and the patient in diastole!

The sysytolic BP is the number when you first hear the beat. I would not consider the systolic as the first time the needle moves as this is very inaccurate.

Hi bmdressen,

I agree with the previous posters. I'm going to also add, even though you did not ask and may already know this, that the size of the bp cuff is important for accurate readings. This is something that has been researched in recent years due to the aging of the population, the increase use of prescription meds, and especially the alarmingly large number of people that die from adverse effects of treatment each year. I find that many facilities, even hospitals do not invest in various sized bp cuffs in an effort to save money. However, many a patient, particularly the frail elderly, have suffered adverse effects of treatment due to incorrect bp readings. If you only have standard bp cuff sizes in your facility, but not "standard" sized clients, you may want to bring this to the attention of administration. Best wishes.

I also wanted to respond to your question/comment. I just started nursing school at the Medical College of Georgia in Augusta and our first clinic work was taking vital signs. Although you see the jump appear, I have been taught to record the BP when you first hear the beats and then the diastolic when you last hear the last sound. Sometimes I, too, have to train myself to strickly listen for the beats because it is easy to get distracted by seeing the needle jump; you immediately think you should have heard something at that moment. Good luck in your new environment!!

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