can't do blood pressure

JDZ344 · Mar 23, 2012

Practise! It took me forever to learn to do them, but now I'm a whizz

Do you have people you can practise on at home?

Double-Helix, BSN, RN · Mar 23, 2012

Are you listening in the right spot? You need to palpate the anticubital artery and place your stethoscope directly over the artery. Pump on the cuff initially while feeling the radial pulse and note the point on your cuff where the pulse stops. Then deflate the cuff and let the patient relax for a few minutes. Then pump up the cuff again to 30mmHg higher then where the pulse stopped. Deflate your cuff very slowly (about 2mmHg every second. This is very slow and I'm guessing you're doing it much faster in a effort to be quicker at the skill. Don't.) Expect to hear the first sounds (systolic) at about 10mmHg on either side of where the radial pulse vanished on your initial check.

Regardless of whether this is a skill you get tested on for your license (and I think CNA's should be required to perform all skills on their exam, not just a few), taking blood pressure is an essential skill to your job and accuracy is extremely important. Medications will be given or not given based on the blood pressure you take. A high or low blood pressure can indicate a serious change in the patient's condition and you need to be able to accurately assess this vital sign.

You need to sit down with one of your teachers and ask her to go over the skill with you. Observe your technique, give you advice, and show you what to do differently. You need to do this until you are able to take a blood pressure proficiently. Not so you can pass your test, but so you can safely take care of your patients.

nguyency77, CNA · Mar 23, 2012

I agree with Ashley; you may not be listening in the right area. For most people, the pulse can be found either toward the middle of their elbow or more toward the side in the direction of their pinkie.

Make sure your stethoscope is placed flat and pressed firmly to the arm. If it's not all the way down, you're not going to hear anything. What you hear should be a clear, distinct sound. The first one is the systolic and the last distinct sound is the diastolic. The cuff should be released slowly-- not so slowly that the patient is complaining that they can't feel their arm, but enough so that you can watch the needle.

Hope that helped! I didn't have trouble with BP in school partly because I learned how to do it as a volunteer, but I had many friends who did. You've gotta keep at it! :) Stay positive, and work with your teacher. BP is such an important skill. My aunt is a renal nurse, and she used to work a lot with a tech who could not take BP to save her life. She would make up random numbers like "Mrs. So-And-So's bp is 130/20." And my aunt would always ask her if it was high or low, just to see what she said. My poor aunt had to keep retaking the BP herself, and I think we can all guess what happened to that tech. :no:

Esme12, ASN, BSN, RN · Mar 23, 2012

Sooooo nervous this is going to be one of my skills...and I can't grasp it. I just don't hear the thumps...and when I think I do...I am way off. Omg I dont know what to do if I fail my exam for this. Any suggestions??

Hint......listen for a gentle sound when you see the needle on the B'P cuff jump. It's like a soft distant heart beat.

fuzzywuzzy, CNA · Mar 23, 2012

Maybe you're moving around too much. If you bump/tap/shift/shift the stethoscope or the cuff while you're listening for the heart sounds, it can make a distracting noise.

Or it could be your equipment. I couldn't take a BP on the crappy stuff they had us use in CNA class. The first time I had to get a manual BP at work I thought I would have to ask for help, but I decided to give it a try first and I had zero trouble. We do have a few of those bad stethoscopes hanging around, and I still can't hear a thing through them, but the nurses always have good ones in the med cart that you can borrow.

nguyency77, CNA · Mar 25, 2012

I just thought of something. There was a classmate I had who could not do BP very well. It wasn't that her technique was off or anything, but it was because the diaphragm of the stethoscope was lined up to the wrong side! When we turned it around, it was fine.

This also sounds very basic but... be sure that the earpieces are facing the right direction too. If their pointed toward your backside, you also will not hear anything! :)

azcna · Mar 25, 2012

A good stethoscope makes all the difference. The one I had for cna training was terrible, but the one I got for nursing school is great and I can hear everything no problem!

Thujone · Mar 26, 2012

1. Locate the brachial artery.

2. place the BP cuff arrow pointing directly above this area.

3. Put your stethoscope in your ears.

4. Relocate the brachial artery.

5. place the diaphragm of the stethoscope of the artery area.

6. Tighten pressure valve, and pump up to about 160 or what ever your state recommends.

7. Release pressure valve and the first beat that you hear that is in a series of beats (their really called korotkoff sounds) will be the systolic, the beginning beats are usually short and high pitched, but fairly strong. Once the beats start to wear away the last beat you hear which should sound very faint will be the diastolic blood pressure.

P.S: try to place the arm that BP is being taken on is placed at heart level.