Please help I cant hear vitals

[sdcb42506]

Ok so i have been a medical assistant/lpn:mad: for a couple of months now. I work for the most anal primary care group. when i take a blood pressure sometimes i can get 120/80 and some how when the dr checks it again on ther "md recheck" they can sometimes come out with a reading of 150/90! how can that be? Can a persons blood pressure change so drastically within a 5-10 time span? if not then what am i doing wrong. I use the right size cuff. I place it right where the artery sign is over artery and i sometimes get way off readings and sometimes cant hear anything at all. is that also normal.. and my biggest concern is taking a blood pressure on a overweight person waying over 300lbs...taking their blood pressure with a thigh cuff, first of all i can get the cuff over ther arm cuz th cuff is so wide and their arms are so large and short. one of the other medical assistants said its normal to but scethescop under cuff but i cant hear a thing. I do not want to give false readings and i want to be a pro at taking blood pressures. can someone help?

[BabyLady, BSN, RN]

Yes, first, you need a good quality stethescope because some people can be difficult to hear.

Second, I find that if a patient's arm is outstretched, finding the artery is easier.

Third, find the brachial pulse first, THAT is where your stethescope needs to go so you can hear it.

Make sure the patient doesn't talk while you take it.

The other reason for a drastic difference is if the patient was at rest when you took it, and then moved around when someone else took it, that can cause the higher reading, especially if someone is easily fatigued.

[~Mi Vida Loca~RN, ASN, RN]

You have gotten some good responses, I have a question though that stood out to me in your post, you said you are a medical assistant/lpn for a few months now. So are you a MA or an LPN?

[sdcb42506]

right now i am a ma but my position is in a hospital so the title and description hires either a lpn or ma to do the job but i am starting program this sept

[~Mi Vida Loca~RN, ASN, RN]

Huh, weird, I have never heard of a MA or LPN title being interchangeable or anywhere near the same thing. One is a nurse and the other isn't. We have a few MA's in our hospital but they aren't considered LPN's and can't do most of what the LPN can do.

So can you pass out Meds in your hospital and do IV's an stuff?

Anyway, thanks for clearing that up and congrats on starting nursing school :)

[sdcb42506]

no i cant do that stuff...its an off site across the st from the hospital a satelite office and i can do the vitals..blood work and assist for pre op

[LovebugLPN]

The point is, in your original post, you said you were a MA/LPN. You are a MA, right? You are not a LPN? So you shouldn't be suggesting that you are one unless that is true. It leads people to believe false things.

[wahwahgerman]

Yes, first, you need a good quality stethescope because some people can be difficult to hear.

Second, I find that if a patient's arm is outstretched, finding the artery is easier.

Third, find the brachial pulse first, THAT is where your stethescope needs to go so you can hear it.

Make sure the patient doesn't talk while you take it.

The other reason for a drastic difference is if the patient was at rest when you took it, and then moved around when someone else took it, that can cause the higher reading, especially if someone is easily fatigued.

All of this is good advice! If you're having trouble palpating the brachial pulse, use all of your fingers and lay them from the antecubital space in the medial direction (i.e. your ring finger would hit the middle of the antecubital space and your index finger would be located most medially on the arm). If you feel for a pulse in this manner, you will pick it up easier that poking around and trying to find it with 2 fingers :)

[sdcb42506]

thank you all so much for your great advice i appreciate it!