Two different blood pressure readings?

  1. Hi,
    what would be causes for different blood pressure readings in young adults.
    I looked uo causes for the elder but can't find any for the younger population.

    Also, which reading to you take?
    Example: If you were to give a patient a BP med and BP was low and you checked the other arm and BP was WNL.
    Which do you accept?
  2. Visit 8Lovenursing8 profile page

    About 8Lovenursing8

    Joined: Aug '18; Posts: 44; Likes: 20

    18 Comments

  3. by   Triddin
    I would check the low side again in 5 mins
  4. by   TriciaJ
    What's your instructor's take on it?
  5. by   8Lovenursing8
    Quote from TriciaJ
    What's your instructor's take on it?
    I'm not in college. I'm a nurse
  6. by   brownbook
    Are these young adult patients in an acute care hospital? What is their underlying illness?

    Some more information would be helpful. How "low" is low? How much difference in the readings?

    BP can easily change 5 - 10 points within a few minutes for a variety of reasons.
  7. by   8Lovenursing8
    Quote from brownbook
    Are these young adult patients in an acute care hospital? What is their underlying illness?

    Some more information would be helpful. How "low" is low? How much difference in the readings?

    BP can easily change 5 - 10 points within a few minutes for a variety of reasons.
    For instance.
    I have a patient and the morning nurse readings are always higher.
    When I take them they're always low.
    So I asked which arm did the morning nurse take his BP.
    He said his right and his vitals were normal.
    Left arm 110/56 52
    Right arm 128/68 67

    To answer your first question.
    i work in the psych hospital
    Last edit by 8Lovenursing8 on Aug 8
  8. by   elijahvegas
    blood pressures are dynamic, they never stay exactly the same. a good example of this is if you've ever seen a CPV monitor or ART line put in. you'll see it change second by second.

    the same goes for if you're switching arms. however if you're consistently getting 2 different pressures with each arm where each respective arm trends the same (e.g. left arm SPB 110, 115, 109 vs right arm 125, 130, 127) it usually signals circulatory or cholesterol issues, possible clots, I cant remember the term for it off the top of my head though
  9. by   8Lovenursing8
    Quote from elijahvegas
    blood pressures are dynamic, they never stay exactly the same. a good example of this is if you've ever seen a CPV monitor or ART line put in. you'll see it change second by second.

    the same goes for if you're switching arms. however if you're consistently getting 2 different pressures with each arm where each respective arm trends the same (e.g. left arm SPB 110, 115, 109 vs right arm 125, 130, 127) it usually signals circulatory or cholesterol issues, possible clots, I cant remember the term for it off the top of my head though
    Thank you! Great answer!!
    Go you remember which do you go off on the lower or higher?
  10. by   203bravo
    you shouldn't "go" with or accept any reading to be more valid than the other... both pressures should be charted including which arm and position of the patient (standing, sitting, semi-fowlers, etc) and the provider made aware of the differences.
  11. by   EllaBella1
    If you have parameters to hold meds based on BP, and one of the BPs was under the parameters, I would hold. You could always recheck both arms in an hour and give the med then if it applies.
  12. by   peachtreednurse
    I was taught left arm preferred; double check with right arm reading; if taking antihypertensive the standard hold was 100/60 ; 110/60 and the higher reading comparing R to L was the one to go by, for receiving med. Also finding is reportable due to significance of attributable causes from clotting, to arterial disease, injury, etc. keeping in mind that literally dozens of factors influence BP and often vary from check to check for intrinsic and extrinsic reasons.
  13. by   psu_213
    Quote from peachtreednurse
    if taking antihypertensive the standard hold was 100/60
    Not trying to criticize, but be careful with saying there is some overarching hold parameters. I have seen a hold parameter for SBP < 140...and, yes, I did confirm that is what the doctor meant to write. If you have any questions about whether or not to hold a BP med, talk to the doctor. Every patient is different, and different patients have different BP goals.
  14. by   brownbook
    " A significant difference in the pressure recorded in the right and left arms can signal circulatory problems that may lead to stroke, peripheral artery disease, or other cardiovascular problems.

    British researchers looked at the results of 20 studies in which blood pressure was measured in both arms. People with an arm-to-arm difference of 15 points or more were twice as likely to have peripheral artery disease-essentially cholesterol-clogged arteries in the arms, legs, or other non-heart parts of the body. The name may sound dismissive, but the disease isn't. Peripheral artery disease affects at least 12 million Americans, more than heart disease and stroke combined. It kills some, maims others, and makes life painful for countless more.

    A blood pressure difference of 10 to 15 points or more between arms also boosted the chances of having a stroke or dying from cardiovascular disease. The results were published online in The Lancet.

    In an editorial accompanying the article, Drs. Richard McManus and Jonathan Mant of the University of Oxford say that measuring blood pressure in both arms should be part of routine medical care.

    Why does blood pressure differ between arms?
    Different blood pressure readings in the right and left arms that vary by a few points aren't anything to worry about. It's actually quite normal. A difference of more than 10 points, though, could suggest trouble.

    In younger people, side-to-side differences in blood pressure can occur when a muscle or something else compresses an artery supplying the arm, or by a structural problem that prevents smooth blood flow through an artery.

    In older people, it's usually due to a blockage arising from atherosclerosis, the artery-clogging disease process at the root of most heart attacks, strokes, peripheral artery disease, and other cardiovascular conditions.

    A less common cause of blood pressure that is different in each arm is an aortic dissection. This is a tear inside the wall of the aorta, the main pipeline of oxygenated blood from the heart to the body."



    If your patient has 10 to 15 points different blood pressures between the right and left arm his PCP needs to be notified and he certainly has more significant problems than which numbers to use for giving him his blood pressure medication.

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