Question about BP

[jschut]

Scenario:

Daughter is 9 months pregnant, has had trouble with high BP throughout....I am taking BP twice daily.

Manually (using cuff and stethoscope), BP is higher...almost dangerously high.

This has been the case here at home, and at doctor's office.

Sunday, BP was 166/102 manually....we went to hospital.

Digital cuff on upper arm had BP as normal, and we were sent home.

I have a wrist cuff at home and it is also reading normal numbers. But the manual cuff still reads high.

I feel more inclined to believe what I hear instead of what I see. But I am still curious....

Why the difference? I'm glad we (she) has an OB appointment today and this is almost over with!

[The Sphynx]

I would check the calibration of the manuel cuff first. Manuel pressure would seem more definitive but it's easy for the calibration to be off and

not properly checked by biomed.

Its little things like that that get easily overlooked.

[kids]

Given the type of discrepancies the manual being out of calibration is one of the first things that came to mind for me also.

[ceecel.dee, MSN, RN]

I'm sure you are already doing this, but log all of your readings, and send the log with your DD for all appointments so that doc can see the trends.

Always have her sit for a full 5 min prior to taking a reading, always use the same arm, always encourage that she is caffeine free.

Keep up the good work as her advocate!

[jschut, BSN, RN]

She had edema yes...protein no...

Yesterday doc admitted her at 37 w 1 day and gave her cervidel...this Am they started pitocin. So today's the day....now, even the digital cuff at teh hosp same room we were in Sunday when we were sent home) is reading high....she's started on Mag too....I'm home to shower, so I had better get it done~!

Thanks everyone and will keep you posted!

[carrie13]

I actually had this same problem but in reverse. I was in the ER after a minor car accident and when triaged my BP was through the roof. The Dr wanted to admit me right away because it was coming up as dangerously high. I don't have a history of high BP so I was a little shocked at how high it was. Luckily the nurse didn't trust the machine and hunted down a manual cuff - she took my BP twice on each arm over the next 1/2 hour to make sure and each time it came up normal. If she hadn't done that I probably would've been admitted and drugged for no reason.

The machine is nice for a guideline but anytime the results are not what is expected or completely out of line with the patient's normal I would definitely use the manual BP for confirmation.

[jschut, BSN, RN]

Well....he's here. About 9p her BP shot thru the roof..higher than it's ever been, so even though she was progressing nicely, they didn't want to wait any longer and did a section....

My grandson, JAcen was born at 10:26p, weighing 5lb 15oz...Mom and babe are doing great...grandma is pretty exhausted, and has sent pics to Daddy in Iraq, and is now going to bed for awhile....

[Gompers, BSN, RN]

Congratulations!!!!!!!!!!! :)

I would always trust a manual BP over a machine. There is something about hearing it for yourself, you know?

Unfortunately, where I work we almost always use automatic BP machines - they are integrated right into our cardiac monitors. The only time it's acceptable to do "real" BPs is when the monitor is not able to get a pressue at all - which sometimes happens in neonates who are hypotensive. Of course we can't use a stethescope on a preemie when doing a BP, so we use a doppler instead. I actually had to do this last night at work - had a baby on Dopamine and needed BPs every 30-60 minutes and the automatic would just NOT pick up. Doppler pressures where 28-40 systolic. Hmmmm...the automatic has picked up pressures for me as low as 14/9 (post-op baby in shock) so why not 28-40??? Those machines are crap sometimes!!!