Question about Blood Pressure

NICU_Nurse, BSN, RN · Jul 14, 2003

LOL!!! Carolanne, you just made me choke on my milk!

Born2BAnurse · Jul 14, 2003

IM like you Heather I still have a hard time doing BP... and when I start clinicals I will be using the machines that does everything for you.. My question is I never used this kind of machine so do I ask my instructor to show me or do I ask the nurse im working under???

Tiki_Torch · Jul 14, 2003

born2banurse,

i'd imagine that if you are in a "clinical" situation and your instructor is present, that you would ask her/him, at the beginniing of the shift, whether the instructor or the nurse-preceptor is to teach you how to use the blood pressure machine.

it's just like using your thinking and applying the "nursing process" to your work... assessment comes first, and so you'd realize that before you implement any action, you must first make a plan. part of the planning and assessment in this case would be to figure out that (1) you need to obtain a blood pressure and other vital signs the machine records, as well as (2) that you need to learn how to work the machine first. if your instructor is present i'd suggest deferring all questions to that person first. they will tell you who will teach you the things you need to know.

most of those machines work in a very similar way, but some have little differences. some even require you take two blood pressures on a patient because the machine is calibrating itself to the particular patient duirng the first attempt. be sure to wait at least 1 full minute before repeating the blood pressure on the same arm though.

when i was in school we were required to use the manual b/p machines and do our pulse checks manually. nearly every floor has either a portable manual b/p sphygmomanometer or individual ones on a wall near the bed of each patient. this is because we all must remember that machines are machines and cannot always be relied on. always remember that! when you receive an unusual reading from any machine it's best to look for problems with the machine's operation first. that's why if the machine says someone's b/p is unusually high or low or deviating from their normal in some way, that you would automatically retake it using the manual cuff. this is what a "reasonably prudent nurse would do in a similar situation" and this is what the law expects of us.

:wink2:

carolanne,

i've had the blood pressure bladder come out of the cuff and fly all around when using a b/p machine too. in my case it was because the cuff cover, which has velcro keeping it closed, was not completely stuck together well enough. when the bladder filled with air, it "escaped" through the loosened velcro closure area. turning off the machine, squeezing out the air from the bladder, reinserting the bladder correctly (so that the arrows one the bladder line up with the arrows on the cuff), and making sure the velcro was really tightly and properly connected made all the difference when i retook the blood pressure. when this happens to you in front of a patient it can be rather unnerving, but a giggle and a smile usually goes a long way in diffusing such situations. i'd usually giggle, smile, immediately turn off the machine, and make some comment about how these machines can sometimes act up. the patient usually giggles or smiles too and when they see you know how to repair the problem quickly this installs their confidence in you. things like this happen in life as well as in the hospital/clinics. anyway, in my case this is what caused my cuff to blow up to the max like a balloon and fly all around.

:chuckle

l_wheat · Jul 15, 2003

I hate manula BP but I guess you have to know how to go about it. I have trouble in that I always hear my fingers creak when Im holding the stethescope down on the arm, UGH I hate that.

Chaya, ASN, RN · Jul 15, 2003

Heather- I make sure the pt's palm is facing up so the thumb is out and I have them keep the arm straight but relaxed. Then I make sure to locate the pulse on the side closest to the pt's body in the antecubital area before I place the bell. This gives me the most consistent results. Good luck!

RNinRubySlippers, BSN, RN · Jul 15, 2003

Just practice as much as you can. I had probs when I first leart as well. My BF has AWESOME veins I practiced on! So did some of my fellow students! He was more than willing! :)

Umm , also, BREATHE! I was extremely nervous and I could hear my own heartbeat! LOL! I am on summer break from school and can assure you I will be re practicing before I go back, even though I got very good at it! PRACTICE PRACTICE AND MORE PARCTICE! Good Luck and let us knowo haw it goes!

RainbowzLPN, LPN · Jul 15, 2003

When I was learning how to take a BP in my aide course, we had to feel the arm of the other person to find where the brachial(sp) pulse is stronger, this was a big help when it came to LOL who had pulses that were hard to find. Good Luck!

jadednurse · Jul 15, 2003

Originally posted by Bex_SRN
My BF has AWESOME veins I practiced on! So did some of my fellow students!

Not to be nitpicky, but I've seen this posted a few times already...when you auscultate a blood pressure, you're listening blood flow through an artery, not a vein. Big veins got nothin' to do with it!

Agree w/ others though: practice, practice, practice! And BTW, we all felt clumsy and unsure of ourselves when we started too. Don't worry, you'll get the hang of it!

kwagner_51 · Jul 15, 2003

Heather,

I have a dial gauge on my BP Cuff. I watch the gauge. When it starts moving at about 120 then I let the air out slowly until it stops. I don't try to listen UNTIL I have watched the gauge 4 or 5 times. Then It is easy to listen. When I first started, I couldn't do it!! I got so frustrated, until I watched the gauge. Now I can find it with no problems!!

I also practiced on myself. My normal BP is 90/60. Back in Dec. I had a severe reaction to a Tetorifice shot. When I went to the dr. my BP was 140/120!!! I could feel my heart beating in my face!! It was scary!!

Hope this helps!

Good luck!

In His Grace,

Karen