Blood pressure-weird jump when taking it

[Communitynurse365]

Hi all:) hoping this is okay to post here... I was taking someone's blood pressure In community today and there was this weird 'bound' at around 160 (I could feel a big bound in pulse near elbow) and also see it on sphygmomanometer. I then couldn't hear anything else until 118 which I then heard until around 60. I remember learning something about this in nursing school but couldn't remember what it was. Any ideas? Sorry the explanation is so bad haha. The man stated he was very nervous.

[firstinfamily, RN]

Did you compare the right to the left?? The sounds are called Korotokoff sounds and apparently there are five. If the patient had an aterio-venous graft that is no longer in use, you will also hear abnormal sounds. Everyone should avoid taking any B/P in an arm that has had an A/V fistula. However, I did have a patient once who had one in each arm, the old one was no longer functional but that arm was the one I had to take the B/P in, it did have abnormal sounds and the B/P was not accurate. Difficult to judge blood pressure medication effects in this patient!!! The loudest Korotokoff should be the systolic and the last the diastolic, it sounds like he did not have any between some of the readings. ?Vascular Disease present??

[dudette10, MSN, RN]

Was it an auscultatory gap? I've seen those in dialysis patients due to decreased vascular "stretchiness"

Don't laugh at my creative use of pseudo-medical terms. I'm tired and I can't think of the proper words!

[K+MgSO4, BSN]

First korokoff sound