Help with BP sounds?

BacktotheBeach, ADN, BSN, RN · Jan 10, 2011

this site helped me learn what to listen for.

http://www.abdn.ac.uk/medical/bhs/tutorial/q1.htm

jojonightengaleGN · Jan 10, 2011

Here's my predicament...
I started nursing school last week (yay!) and we have validations on taking blood pressures this Friday morning. I was planning to practice in the lab every day this week, but as it turns out, I'll be snowed in at home til at least Wednesday afternoon! That only leaves me with about 4 hours practice time in the lab before validations...
When we learned last week, I had horrible trouble hearing the sounds, and I know I'm not prepared at all to pass off on validations. Are there any good websites online to practice hearing the sounds? I'm pretty good at finding the diastolic, but I can rarely get the correct systolic. Part of my problem is that my hands shake, and I can hear it through the scope. I use a Littmann Classic SEII, but we have to use generic double-headed steths for validations so the instructors can check, and our answer has to be +/-4mmHg of what they hear.
Any advice/tips are much appreciated! :)

Are you testing on Friday on an actual HUMAN?? Or on a SIMS person??

symphie · Jan 10, 2011

Are you testing on Friday on an actual HUMAN?? Or on a SIMS person??

An actual person. We go in with a partner. The instructors use double stethoscopes so they can listen in while we figure out our partner's BP.

symphie · Jan 10, 2011

this site helped me learn what to listen for.
http://www.abdn.ac.uk/medical/bhs/tutorial/q1.htm

Thank you! Thank you! Thank you! :)

jojonightengaleGN · Jan 10, 2011

:redbeathe:clown::redbeathe

You are going to do fine!!

Here's a tip, an MD taught me when I was having difficulty "clearly" hearing BP sounds.

Hopefully your partner has a good brachial pulse!!

Put on the cuff, prior to inflating - use your pointer and index finger ONLY to get a good feel for your partners' brachial pulse; Use that for exactly WHERE TO PLACE the stethoscope. ( I mean, place it directly over where you felt the pulse ... take your time!!)

Then inflate cuff, don't rush you need to watch the mercury

I hope that helps you... God will guide you !!

Good Luck, you are in my prayers!!

You got this!!

Jo Anne :nurse:

VioletKaliLPN, LPN · Jan 11, 2011

can you afford to purchase a cuff? i bought one and used it to practice. everyone in my family had their bp taken.

CrazierThanYou · Jan 11, 2011

:redbeathe:clown::redbeathe
You are going to do fine!!
Here's a tip, an MD taught me when I was having difficulty "clearly" hearing BP sounds.
Hopefully your partner has a good brachial pulse!!
Put on the cuff, prior to inflating - use your pointer and index finger ONLY to get a good feel for your partners' brachial pulse; Use that for exactly WHERE TO PLACE the stethoscope. ( I mean, place it directly over where you felt the pulse ... take your time!!)
Then inflate cuff, don't rush you need to watch the mercury
I hope that helps you... God will guide you !!
Good Luck, you are in my prayers!!
You got this!!
Jo Anne

If we didn't palpate for the brachial pulse beforehand, we failed.

And those double-headed stethoscopes SUCK.

freki, ADN, RN · Jan 11, 2011

The first thing I would say is to remember how lenient +/- 4mmHg is. When I did it, we had +/- 2 or we failed. Palpating a pulse first is a good way to make sure you're actually hearing sounds. Unfortunately sifting through the various sounds you hear through a stethoscope to determine which are Korotkoff sounds and which are not just comes with the territory. The biggest help you can get is to just practice. Before we were allowed to validate (for CNA), we had to take 30 people's vital signs and have them initial that we did them outside of class. This was before we started clinicals, so I did them on every family member and friend that would allow. People are always curious about their BP for some reason, don't be afraid to ask if you can check it.

If you absolutely can't practice enough to satisfy, try ThinkLabs, but don't let it entirely replace practice.

I'm sure you will do fine. I still worry that I'm not hearing the right sounds from time to time after 8 years of doing it. You just have to learn to have confidence in what you're doing. Good luck!