Best way to learn to do B/P

VickyRN, MSN, DNP, RN · Oct 4, 2004

My only advice is to practice, practice, practice. If you don't own your own blood pressure cuff, buy one ASAP. Use it to "practice" on everyone in your family, your friends, any willing neighbor. You will be suprised how it will all come together with LOTS of practice.

PS. While I was in nursing school, I used to "practice" doing BP readings on my then 8-year old son.

jschut, BSN, RN · Oct 4, 2004

I agree with the above...practice, practice, practice!!!

Drysolong · Oct 4, 2004

hello, i am a new lpn student and am a little nervous about learning to do everything. our first check offs in about a week will be vital signs. my main concern is blood pressure. we only did this for a little while one day but i wasnt catching on. i know i will get more practice but would like to know if anyone has any tips on learning to properly take blood pressure. i know the systolic is the first sound u hear and the diastolic is the last but maybe im letting the air out too fast to hear it or something. i would get drastically different readings each time on the same person. anyone? thanks in advance.

i asked a similar question, below is a good detailed answer that i received:

originally posted by drysolong

in one of my classes, we learned the basics of vital signs and infection control. my questions is about taking blood pressure and pulses. i am a novice, so even the simplest duty was rather new to me. i've gotten the radial pulse down. but my real problem is finding the other pulse sites. i passed on demonstration of my skills, but i don't feel competent. i know i will have time to practice these skills, but i would like to know this really good now.

i and my classmates were making a big deal about finding the brachial artery to take the pulse with stethoscope and our teacher told us not to worry so much about that, but to just take the reading. but i can't hear the sounds, and i think it's because i don't have the stethoscope positioned on the brachial artery. what am i missing? also, how often do you in real world take pulse at all the various sites? also how many of you use stethoscope to take blook pressure? thank you

pulses and blood pressure - can be difficult at first, but get easier with time and provide critical information about your patient (many people think of them as mundane "chores" but they are important parts of the assessment).

i take pulse at all the various sites at each assessment, but - to be fair - i work in an intensive care environment. if you felt a distal pulse at 8 and do not feel one at 12 - red flag - where's that doppler? i guess it is not done as frequently in med/surg, but it really provides important information about cv function, hydration status, bp (as systolic bp drops, you lose your distal pulses - patient may start exhibiting s/s shock - if you can feel a carotid pulse, sbp is usually at least 60. if you can feel carotid and femoral, sbp usually at least 70. if you can feel the radial, sbp usually at least 80) and perfusion (has your patient had a recent fem/pop? did you lose your pedal pulse in that foot all of a sudden? better call the surgeon!!)

dont mistake the position of the antecubital vein for that of the brachial artery - a common mistake i see is people going for dead center with their stethoscopes. the brachial is on the inner 1/3 of the arm (closest to the body).

i never use a scope to take bp (haha - try that procedure on a squirming 450 gram infant! that would be one for the nursing olympics!). with adults, i would be ok with accepting the dinamap readings for med/surg patients (although i would recommend checking a manual if you get a funky reading).

i accept the art-line reading for icu patients (as long as the wave form is ok) and palpate the bp for patients in shock - for really shocky patients, may have to doppler the bp, but hopefully the patient would have an a-line at that point.

manual bp is a good skill to master. if you need a bp and the dinamaps are in use/not working/not available, just slap that cuff on and get to it. it really does get easier the more you do it - just like anything else. :)

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WildShot · Oct 5, 2004

Heya,

Another Nursing student here :) . I had problems with taking a blood pressure, I went to my nursing tutor and she helped me alot. she explained to me that the brachial Is usually on the pinky side of the hand and if you have the patient make a fist and place it under the elbow so that it hyper-extends the arm, then place your first three fingers length-wise across the fold in the arm on the pinky side, you can usually feel the brachial pulse. She said it, I did it, it worked (atleast for me) Since I am a guy I can usually now wrap my hand around most peoples elbows and hold the stethescope on the brachial all with the same hand I found the Brachial everytime and heard it alot better. I know this isnt very technical, but it was a wonderful help for me and I hope it might help you also.I took a blood pressure on anything that would and wouldnt move and still do. (p.s. my neighbor had a arterioectomy and had me try and take her B/P ha ha) good luck in school

Shotsy

VickyRN, MSN, DNP, RN · Oct 5, 2004

Great advice here! :)

ayndim · Oct 5, 2004

Hello, I am a new LPN student and am a little nervous about learning to do everything. Our first check offs in about a week will be vital signs. My main concern is blood pressure. We only did this for a little while one day but I wasnt catching on. I know I will get more practice but would like to know if anyone has any tips on learning to properly take blood pressure. I know the systolic is the first sound u hear and the diastolic is the last but maybe Im letting the air out too fast to hear it or something. I would get drastically different readings each time on the same person. Anyone? thanks in advance.

Go to the drug store and buy one of the models that people use on themselves. Just make sure to get one you have to listen to (it will come with an attached steth). The instructions are so easy that anyone could understand it. I haven't even done the CNA portion of the RN program and I have already learned BP by practicing on myself.

Maggie in NC · Oct 5, 2004

My dad has a digital B/P reader so I would practice with my Steth and checked it with his digital. That really helped!

Another thing that helped me...

I can't hear very well so, I had to get a better steth-a master cardio-it was the major difference for me. I can hear and catch the b/p every time now!

Hope that helps!

lil' girl, LPN · Oct 6, 2004

are you using the bell side of your scope?

mona b RN, BSN, RN · Oct 6, 2004

Hello, I am a new LPN student and am a little nervous about learning to do everything. Our first check offs in about a week will be vital signs. My main concern is blood pressure. We only did this for a little while one day but I wasnt catching on. I know I will get more practice but would like to know if anyone has any tips on learning to properly take blood pressure. I know the systolic is the first sound u hear and the diastolic is the last but maybe Im letting the air out too fast to hear it or something. I would get drastically different readings each time on the same person. Anyone? thanks in advance.

It does take practice. I am also a student and I have a hard time hearing the sounds. Part of it is due to the very noisy environment where I do clinical. Keep practicing, you'll get it. I find that if the earpieces are not firmly in my ears I cannot hear a darned thing. Must be gettin' old :chuckle

mona

sad · Oct 15, 2004

Hello, I am a new LPN student and am a little nervous about learning to do everything. Our first check offs in about a week will be vital signs. My main concern is blood pressure. We only did this for a little while one day but I wasnt catching on. I know I will get more practice but would like to know if anyone has any tips on learning to properly take blood pressure. I know the systolic is the first sound u hear and the diastolic is the last but maybe Im letting the air out too fast to hear it or something. I would get drastically different readings each time on the same person. Anyone? thanks in advance.

You can practice on yourself. Make sure everytime you get the correct figures when you do it yourself.

ATB · Oct 16, 2004

How great to find the info on BP. Im taking a CNA "crunch" course and we only have a short time to learn correct BP techniques. Our skills test is in a few days so Im madly practicing on any arm that comes my way! I like the hint on using the patients fist under his elbow of the arm you're taking his BP. It "pushes" up the Brachial artery so you can locate it and hear a stronger beat. I will try this as soon as an arm comes through the door! We get a +- 4 on our reading, so I'm a tad nervous, but know its the practice, practice and more practice that will get me through the test. We have to find the pulse first to obliterate it, before doing the second reading with the brachial artery. They issued us rather "generic" steth and cuff with manometer. Instructor said when we learn on this equipment we learn the "gold standard" of BP readings. Also, that hospitals have stockpiled these old cuffs in case of a huge disaster and the elec. ones wont work. So, we need to know how to take BP's with this equipment.

Regardless...still worried as we have such a short period of time (10 days) to feel like I know what Im doing! Wish I could give you more advice.....only letting you know Im in the same boat as you! Good luck to us both!