Taking patient's blood pressure

Nursing Students CNA/MA

Published

I'm a CNA and I have a question to ask of those more experienced than I in taking a blood pressure.

I am finding that I am having more trouble "hearing" the diastolic and systolic readings. Is it possible that my slight hearing deficit could make it difficult for me to accurately take a blood pressure? This may be a 'no brainer' but I need to be accurate in task.

Any thoughts are greatly appreciated.

Lin

Hospice CNA

One thing that helped me was to lay in bed and with the same fingers I take pulse, I found my brachial pulse. That took awhile. In class we were not told to take it anywhere but the crease of the elbow. So once I found my brachial pulse, I started placing my stethoscope in about the same spot on all of my practice partners in class. Made all the difference in the world. I went from never being able to for sure hear it to being able to tell what was going on. I found for most - it is easier to hear way on the inside of the arm about almost under the bicept.

Up Vote Up Vote ×

Alot of people have offered good advice! Here are some of my tips:

1. Obviously make sure that you are using a quality stethoscope since you are slightly hoh. However I don't think you need to spend tons of money on it.

2. When you place the bell of the sethoscope on the patients arm place it over the brachial (sp) artery not just in the center of the bend of the arm. The brachial artery is medially located and is what you are actually listening to. Dont be afraid to push down with the bell a little bit. Just resting the bell over the artery isn't going to yield a very good sound no matter how expensive your stethoscope is. If you hear a beat as soon as you start deflating the cuff, pump the cuff up a little more and then deflate slowly. You should never hear a beat as soon as you start deflating, there should be a moment or two of silence first. This is how you will know that your systolic is correct. Also if you are not sure that you really heard the dystolic pump the cuff back up a little bit more and try again. The pressure of the cuff when listening for the dystolic usually isn't painful and shouldn't bother the pt.

3. Deflate the cuff slowly!!!! Going too fast will make it very difficult to hear either the systolic or dystolic! This is soooo important! When I first became a CNA I had to concentration on doing this. Many patients complaine about the pressure (which made me deflate the cuff quickly) but I will tell you that going slowly and getting it right the first time is much better than being unsure about your reading and/or having to reinflate the cuff. Also if you take just a moment to look at the pts vitals you will know about when to expect the systolic/dystolic. If your pt has not a had a bp higher than 140/80 then you only need to inflate the cuff to about 150. Deflate slowly and the listen for the first beat. You can delfate it quicker after the first beat and then when you get to about 90 slow it down and listen for that last beat.

4. Lastly make sure the patient extends their arm all the way and that the arm is supported to minimize movement. Mute any tv's, radio's, ect and don't be afraid to ask the family/friends/pt to be quite for just a moment while you take the bp. They are usually always happy to comply. The more practice you have the easier it will get I promise! Good luck!

Up Vote Up Vote ×

Thanks for the help. I took the skills test over and by the look on the testers face and her not asking me if i wanted to take my vitals over I would say I passed. I still have to wait 2-4 weeks to get my results. I am so happy:yeah:

Up Vote Up Vote ×
i'm a cna and i have a question to ask of those more experienced than i in taking a blood pressure.

i am finding that i am having more trouble "hearing" the diastolic and systolic readings. is it possible that my slight hearing deficit could make it difficult for me to accurately take a blood pressure? this may be a 'no brainer' but i need to be accurate in task.

any thoughts are greatly appreciated.

lin

hospice cna

hi there! i'm presently going through all of my orientations for a job i got in a hospital. one of the new tricks i was told, was to turn the ear pieces in towards your nose...this will help you to hear better. i didn't even know that they would turn back and forth like that. also, don't forget that if you can't hear anything...tap on the bell and make sure that it's working. if not, turn it until it does...you will definitely hear the difference. it's also very easy to find the artery in the bend of the arm...start at their pinky and work your way up inside their arm to the bend of their arm, and that is where it will be. however, during state test make sure that you at least pretend to be feeling for the pulse first!!...the tester will look for that step if you get that skill. oh, and like everyone else said, deflate the bulb very slow and as soon as you hear a change in the diastolic...that's it. i hope this helps!! good luck!

Up Vote Up Vote ×
I feel the same way the OP does. I'm pretty apprehensive about the state test - I've never actually gotten to take a BP myself - only listened/watched videos in class. I can't afford to buy the cuff for myself, either. :(

http://www.allheart.com/aneroidbp.html

I got mine on sale here for $10, normal price is $15 nothing too fancy, but affordable and something to practice with

Up Vote Up Vote ×

This sounds crazy, but helped me tremendously.....be able to multitask and here it goes. hold the bell with your left hand over brachial artery, with your right hand control valve releasing very slowly whith thumb and fore finger. same hand with your pinkie slightly pull down on earpiece so it pulls down on the ear canal a bit.

That is the only way I could do it--discovered it by accident and WOW I couldnt believe how loud it was after that.

Up Vote Up Vote ×
Specializes in Basic Nursing/ CNA.

I know what you mean! I had a hard time hearing it the first time I practiced in lab. I still have a hard time here and there, but have gotten better with hours of practice.

Up Vote Up Vote ×
Specializes in Cardiology (ITU), Acute Renal/Dialysis.
You have NO idea how hard is was for me to hear the sounds. I would always be like, huh? Did I hear the who make the what noise? Trust me, you'll get it.

Here are a few personal tips:

  • The stethoscope means a LOT to BP readings. Is it of higher quality? Perhaps you require an amplified one if you're hard of hearing? Can you hear heart sounds okay? Is the placement of the stethoscope correct? Personally, I use a Littmann II Cardiology. I spent $297 on that puppy and it's great clear sound;
  • In addition to the above tip, you do pay for what you get! (trust me!)
  • If you need to take it more than once, DON'T BE EMBARESSED. Just say "Well, gosh darnet I think I missed the last sound! Let's try it on that other arm!". Also as an aid/tech, the nurses should always be willing to do this for you if you need help. Just right down what you believe the BP reading is, give it to the LPN/RN and explain that you had trouble -- he/she should be able to take it for you. No biggie!

In the mean time, check out:

http://www.steeles.com/catalog/takingBP.html

http://deptets.fvtc.edu/nursing/index.htm (Lesson #51)

Great quickie resource I pulled up! If you have any questions, feel free to ask me personally.

Good luck! :lol2:

They're great resources to have, thank you!:redbeathe I will utilise these when mentoring students & junior staff :nurse:

Up Vote Up Vote ×
+ Add a Comment