I failed my Blood pressure assessment

[Bluebrown]

I can always hear diastolic but I can never systolic. The sound is never clear to me. I have a littman classic 2 stethoscope so I don't know if that is the issue. Everybody else in my class has the same steothscope except for some reason I can't hear it. I failed my assessment for BP as I knew I would. I keep practicing but I cant seem to get it. Any tips or suggestions. Anyone else out there who took them a while to get bp. What did you do?

[palamino98]

If you straighten the arm and almost hyperextended it, you'll be able to hear better. Just don't hyperextend it lol

[nyandy]

I agree about the stethoscope. I had the same stethoscope when I started and had difficulty with breath sounds. I finally gave in and upgraded my stethoscope. What an amazing difference. My lab partner was having the same issue you are and I let her use my new stethoscope and bingo.... She never had to guess or be unsure again cause she bought the same one that day. Yes, $200 is alot but I see it as an investment for your future and as long as you keep it close, you will have it for years.

[chwcbesteph, RN]

Make sure the bell of your stethoscope is turned the right way on the tubing!

[betterlatethantardy, MSN, RN]

I agree with the advice for closing your eyes and not looking at the dial. Closing your eyes will help you to focus on listening. You'll get the hang of it! Just keep practicing.

P.S. Closing your eyes also helps when listening to infants heart rates when they're fussing. It helps to focus your hearing.

[chyna016]

If they have a training double stethoscope try listening with an instructor (we used one of these for our test). You might not have it in the right spot.

[0.adamantite]

I don't mean to make light of your situation, but I also failed my blood pressure assessment and had to redo it in nursing school. It was the only skill I failed. I had been working in healthcare for two-three years at this point and it was humiliating. My second time, I remembered to deflate the cuff nice and slow. I am a little hard of hearing so I have to listen very closely.

[elijahvegas, ASN, RN, EMT-P]

well for starters...you dont "hear" the diastolic..what you hear is the systolic blood pressure. the initial tapping is where the systolic is recorded, and at whatever point you CEASE to hear the pulse, is your diastolic pressure.

so maybe the issue isnt quite that youre doing something wrong, but rather, youre not exactly sure what you're listening for, which ends up screwing up your whole reading?

[LyricallyDivine]

Yeah, I agree with JonnyVirgo ... I'm not sure if you just typed it wrong in the post, or if you are just listening/recording your data wrong. Revisit that and try again. Good luck!

[brycross33]

Have you gotten your ears checked lately? It may be because you just have a hard time hearing they have stethoscopes that amplify the sound so you can hear it better they are electronic and I have seen them they cost around 80 bucks if you want to invest in one

[CacaoHeart]

I have a cardiology III and found that I still had trouble hearing well through it until I realized I needed to get my ears cleaned ;-) My doctor has me put a mix of half hydrogen peroxide half isopropyl alcohol in my ears once weekly. Go more than two weeks without it and I start having trouble hearing through the stethoscope again, even though it takes several months of no cleanings to notice any issues in day to day conversation.

[Kuriin, BSN, RN]

Cerumenectomy? Just irrigate it with pressurized water at about 8 PSI.

[nurseprnRN, BSN, RN]

If you straighten the arm and almost hyperextended it, you'll be able to hear better. Just don't hyperextend it lol

Exactly backwards, and this is why: Every big artery you have that could be vulnerable to injury, i.e., the radial, ulnar, popliteals, and bracheals, will pop backwards and hide when a joint is extended (as in fending off danger). Don't believe me? Ask a friend to help you.

Start with the radial. Flex the wrist about 30-45 degrees from straight and palpate the radial pulse in its groove. Now, without moving your fingers, have your subject extend or hyperextend his wrist. See how the radial pulse becomes more difficult to feel. Feel how those tendons and such snap forward over it?

Repeat with the popliteals-- they are in those little grooves on both sides of the back of the knee (check your anatomy book for landmarks). Try with the knee straight and then with it flexed. You will feel them better when it's flexed.

Last, do this experiment with the brachials. Same thing. You always want your patient's elbow slightly-- but passively-- flexed, which is why you tell him to relax, get floppy like a rag doll to get those muscles soft, and you support his forearm on your hip or rest it on the bed or table, to palpate the artery in its groove up against the bone.