need help with blood pressure

[shrimpchips, LPN]

I have successfully completed my first week of nursing school! It is A LOT of work and I have never been so stressed out in my life. After a day of classes I am completely drained and it is really hard for me to try and do my work without falling asleep but so far I have been good with staying on top of things.

Anyway, I'm a little confused with blood pressure. My instructor had us obtain a "baseline" on each other that way when we are tested we know what to pump up to. Do you ALWAYS have to find a "baseline" or is there a number that you can always pump up to in order to get an accurate reading? One of my classmates (who thinks she knows everything) was telling me to simply pump to 200mmHg if you don't want to obtain a baseline and it irritates me because she is already telling me what to do - she isn't my instructor! Pumping to 200mmHg seems a little far-fetched to me. In LRC on Thursday I found out that my baseline is 110 (my partner's is the same too) so she told us to pump to 140mmHg to get an accurate reading - but seriously if someone pumped past 140mmHg on me, my arm would seriously begin to hurt and from 140 to 200mmHg, that's quite a difference in pressure in my opinion.

Also does anybody know of a website where I can practice reading blood pressure?

Thank you everyone and sorry for this ridiculous question!

[Daytonite, BSN, RN]

here you go:

• the virtual blood pressure cuff: http://medicine.osu.edu/exam/ - from ohio state university college of medicine, an interactive guide to physical examination for 8 body systems that includes sounds. has an interactive blood pressure cuff. scroll down the page and click on the "take a blood pressure" link near the bottom of the page. you will be able to hear and watch a blood pressure manometer and tell the program what the final blood pressure is. it re-cycles to give you lots of practice!
  
• http://www.ktl.fi/publications/ehrm/product2/part_iii3.htm - blood pressure measurement where peak inflation level is determined first by palpating a radial pulse, inflating cuff and then determining the point at which the pulse is obliterated.
  
• http://homepage.smc.edu/wissmann_paul/anatomy1/1bloodpressure.html - how to take a blood pressure - an older site
  
• http://www.uams.edu/csc/programs/orientation/bloodpressure.htm - how to take a blood pressure - an older site
  
• http://www.videojug.com/film/how-to-take-your-own-blood-pressure - this is a video on how to take your own bp using a digital cuff--has some very good points about cuff placement and patient positioning

[shrimpchips, LPN]

Thank you very much Daytonite!

[Daytonite, BSN, RN]

here's one more link to a nursing procedure manual (no photos or pictures):

• http://www.mccfl.edu/pages/2472.asp

[Daytonite, BSN, RN]

Just found this terrific video of how to take a blood pressure. It's the first link on the page. Includes sound.

• http://www.brooksidepress.org/Products/Nursing_Fundamentals_II/Videos.htm

And more:

• http://nursing411.org/Courses/MD0531_Taking_Vital_Signs/index.html - tutorials on taking vital signs

[Chelsey19]

You dont need to get a baseline if someone has had similar BP readings in the past...(say if they have been to the doctor for checkups and its 120/78 and the reading has been similar to that a couple times) Then you would pump up the cuff to 150mmHg. The 200mmHg is kind of extreme and I wouldnt listen to that girl just go with what your instructors say... They usually have been around long enough in the nursing profession that they would be the ones to ask if you are unsure..

[Bortaz, MSN, RN]

In all my years as a patient (20 years on antihypertensives) I have never once had a nurse or doctor do a baseline. All the do is crank it up to whatever...170, 180, 200...and then let out the air.

When I told my skills instructor this story, her response was "maybe, but those nurses and doctors aren't grading your skills checkoffs."

Message received.

[znov11]

I think you need to preliminarily palpate the brachial artery as you pump the cuff, then when the pulsation fades or disappears, add at least 10 or maybe 20 mmhg, then release. That prelimnary reading will be your baseline. That's what I learned in my return demo. ^^

[JHansen]

all new pts I go to 180, then after a few bp's i pump too 20 or so above their norm. I find that if you always go to high pressures your pts tend to stress sometimes when you go to take their bp which raises their bp(not something you want)

[Slimlady727]

I think you need to preliminarily palpate the brachial artery as you pump the cuff, then when the pulsation fades or disappears, add at least 10 or maybe 20 mmhg, then release. That prelimnary reading will be your baseline. That's what I learned in my return demo. ^^

We were told to palpate the radial pulse when trying to find the baseline. Once the pulse fades we go 30mmHG above the number of what was shown.

[Kellacan]

We were told to palpate the radial pulse when trying to find the baseline. Once the pulse fades we go 30mmHG above the number of what was shown.

:yeahthat:

We were told this as well and this is what I did on my skills check off.

[znov11]

I think the radial pulse disappears when the brachial pulse disappears, either ways, we can conclude that the artery has been successfully occluded. 30mmHg will also do. ^^