Published Feb 19, 2011
italy
33 Posts
i have a validation soon for blood pressure, pulse, rr, and temp. i seem to have a hard time with bp. we are using the dual stethoscope so the professor can hear it. i'm testing my partner's bp (everyone has partners) and the professor will check it. what are some good ways?
seasoned hopeful
166 Posts
What worked for me was to practice on everyone that you can get to sit down. When you feel more comfortable it will be easier to you. Go through each step in your mind as you do it, to keep yourself on track. There are also a couple of good websites on the sounds that you will hear. You'll get it!!
MissJulie
214 Posts
The way that my CNA instructor taught us was to make sure to feel for the pulse of the brachial artery first, so that you know where to place the stethoscope. Then, make sure to firmly place the steth on the skin, and hold in place with your pointer finger (not your thumb because you could pick-up your radial pulse instead) and begin to pump up the cuff (make sure that the bulb is closed completely) and when you hear the first loud beat (or when the needle on the gauge "jumps"), that's the bottom number. Pump the bulb so that it goes up 20 more and then begin to let the pressure off, when you hear the last beat, that's the bottom number.
Hope it helps!
Strawberrygirl2
51 Posts
Just practice a ton at home and on different people. Everyone is different when it comes to taking blood pressures. Practice on your friends, family, and co-workers! You will find out through practice what method works best for you.
Seawitch
49 Posts
I was the same. You just have to practice, practice, practice and you'll get there!
lilarox
42 Posts
the way that my cna instructor taught us was to make sure to feel for the pulse of the brachial artery first, so that you know where to place the stethoscope. then, make sure to firmly place the steth on the skin, and hold in place with your pointer finger (not your thumb because you could pick-up your radial pulse instead) and begin to pump up the cuff (make sure that the bulb is closed completely) and when you hear the first loud beat (or when the needle on the gauge "jumps"), that's the bottom number. pump the bulb so that it goes up 20 more and then begin to let the pressure off, when you hear the last beat, that's the bottom number.hope it helps!
hope it helps!
just wanted to clarify, but i think you meant that the first loud beat it is the systolic (top number), i usually go to about to about 140-160 (or at least twenty above expected pressure, (you would usually ask the patient what their usual pressure is, or check the chart to see what the last few vitals are) so in this case if you practice with your partner before the review then you will get an idea of the persons usual systolic pressure, and then slowly release air til you hear your last audible beat and that is your diastolic (bottom number). it helps if you can be calm and also the dual scopes aren't very good, so if you can get a (for lack of a better word) a "crappy" stethoscope, then it well help when you do your skills test. and just like everyone else said, practice on any willing person. good luck. :):)
mangopeach
916 Posts
Like everyone else said, practice as much as you can. I was nervous about BP too but with practice, I got better and checked off on my first attempt. This site helped me a lot with the sounds.
http://www.abdn.ac.uk/medical/bhs/tutorial/tutorial.htm
And yeah the double steths are not the greatest. Out of maybe 8 of them in the lab, only 2 of them are really good. The instructors only use the ones that you can hear the best out of though. (At my school that is. They know the other ones are crappy, why they still keep them around is beyond me.) And so I just practiced with my own. My first strategy was to practice with the double steth but since most of them were crappy it was pointless. I never bothered using them. For me it worked better to use a good steth so I could hear clearly.
gpatry
82 Posts
Like everyone said, it's really practice. I hated doing BP at first. I was never sure of what I was hearing. I had no problem with diastolic, but systolic killed me for a long time. Just remember it's the first really clear, loud beat you hear, after all the muffled ones. There shouldn't be any muffled sounds after it, just beats until it stops. The way I got it was to not pay attention to the numbers for the first few times and just really listen to the sounds. Once you figure out what you're listening for, the rest is a breeze. Good luck!
MelissaLPN, ASN, LPN, RN
1 Article; 102 Posts
In nursing school I was always taught to apply the bp cuff and palpate the radial artery while pumping up the cuff. When you can no longer palpate the radial artery this is the " baseline." You then deflate the cuff, palpate for the brachial artery and pump up the cuff 20-30 above baseline. This is very important. I have done this on a client assuming their bp will be near normal. Based on baseline I was able to assess a bp of 298/150!
symphie
96 Posts
1. Feel for the spot where you can feel the brachial pulse the BEST. Then take your time to make sure you're putting the stethoscope EXACTLY where you felt it.
2. Practice different techniques of holding the stethoscope while you take it. You need to be able to hold it firmly without scraping the tubing against your fingers or anything else. For me, it's the stethoscope head between my first and second finger, with my thumb under the person's arm. Everybody's different so find the way you're most comfortable and practice that way.
3. Use the website that mangopeach posted above. It helped me alot with knowing what was the systolic value and what was just "extra noise"
I had to validate the exact same way you are, with the crappy double stethoscopes and everything. It was actually alot easier when I validated than when I was practicing because it was the first time I'd ever gotten to take a BP with the room being completely silent, so I didn't hear any background noise. Good luck! :)
Music in My Heart
1 Article; 4,111 Posts
Be sure you deflate the cuff slowly enough to get a reliable reading when the first Korotkoff sound begins.
Most the MAs that take my BP in the MD offices go way too fast to get an accurate reading.