Medical Question

Nursing Students General Students

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I wasen't sure quite where to put this post. I have a friend who is in nursing school and she was telling me about a patient she was taking care of that had a 10 unit difference in diastolic pressure between his right and left arms. :eek: Is that possible? I am not in nursing school yet so I don't know that answer. Maybe you don't either but I just thought it was weird. :cool:

yes it is possible...

2 reasons of the top of my head:

circulatory difference...various reasons for that

just plain a flucuation in BP...BP is NOT a costant..it is changing all the time....

Depends on the medical diagnosis. It could be changed by a wide variety of things e.g. heart failure, injury, etc.

I'm with Sunny on this one. BP's change all the time, and that is why when you are assessing someone for HTN or other heart/circulatory probs, you should always take the BP in both arms. It can mean there is more sclerosis in one side and if only taken in the "good" arm, it can lead to misdiagnosis.

However, it can also mean nothing. Maybe it was taken wrong, maybe it fluctuated...you never know. Without risk factors, it's probably just the two above.

Kristy

it is possible...it definitely should be properly noted in the nurse's notes....the pt should also be in the same position for each reading (sitting, standing, lying)....also, the pt's chart should be checked for consistency of past B/Ps....the B/P should have also been re-checked at least 15 min later in each arm to rule out any discrepencies....hope this helps...kellygirl

Interesting article on BP variation btwn arms:

http://www.lifeclinic.com/focus/blood/articleView.asp?MessageID=318

thanks for the info. guys! That article is really interesting!

Specializes in ICU-Stepdown.

Sure, its possible. A stroke patient with hemiplegia would be a likely candidate. Anything that could cause a variation in circulation (not the least of which would be a bad heart, clot, even congenital abnormality (making it likely to be 'normal' for that person).

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