Two different blood pressure readings?

Nurses General Nursing

Published

Hi,

what would be causes for different blood pressure readings in young adults.

I looked uo causes for the elder but can't find any for the younger population.

Also, which reading to you take?

Example: If you were to give a patient a BP med and BP was low and you checked the other arm and BP was WNL.

Which do you accept?

Triddin

380 Posts

I would check the low side again in 5 mins

TriciaJ, RN

4,328 Posts

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

What's your instructor's take on it?

8Lovenursing8

42 Posts

What's your instructor's take on it?

I'm not in college. I'm a nurse

brownbook

3,413 Posts

Are these young adult patients in an acute care hospital? What is their underlying illness?

Some more information would be helpful. How "low" is low? How much difference in the readings?

BP can easily change 5 - 10 points within a few minutes for a variety of reasons.

8Lovenursing8

42 Posts

Are these young adult patients in an acute care hospital? What is their underlying illness?

Some more information would be helpful. How "low" is low? How much difference in the readings?

BP can easily change 5 - 10 points within a few minutes for a variety of reasons.

For instance.

I have a patient and the morning nurse readings are always higher.

When I take them they're always low.

So I asked which arm did the morning nurse take his BP.

He said his right and his vitals were normal.

Left arm 110/56 52

Right arm 128/68 67

To answer your first question.

i work in the psych hospital

blood pressures are dynamic, they never stay exactly the same. a good example of this is if you've ever seen a CPV monitor or ART line put in. you'll see it change second by second.

the same goes for if you're switching arms. however if you're consistently getting 2 different pressures with each arm where each respective arm trends the same (e.g. left arm SPB 110, 115, 109 vs right arm 125, 130, 127) it usually signals circulatory or cholesterol issues, possible clots, I cant remember the term for it off the top of my head though

8Lovenursing8

42 Posts

blood pressures are dynamic, they never stay exactly the same. a good example of this is if you've ever seen a CPV monitor or ART line put in. you'll see it change second by second.

the same goes for if you're switching arms. however if you're consistently getting 2 different pressures with each arm where each respective arm trends the same (e.g. left arm SPB 110, 115, 109 vs right arm 125, 130, 127) it usually signals circulatory or cholesterol issues, possible clots, I cant remember the term for it off the top of my head though

Thank you! Great answer!!

Go you remember which do you go off on the lower or higher?

you shouldn't "go" with or accept any reading to be more valid than the other... both pressures should be charted including which arm and position of the patient (standing, sitting, semi-fowlers, etc) and the provider made aware of the differences.

EllaBella1, BSN

377 Posts

Specializes in ICU.

If you have parameters to hold meds based on BP, and one of the BPs was under the parameters, I would hold. You could always recheck both arms in an hour and give the med then if it applies.

Specializes in Med-Surg., LTC,, OB/GYN, L& D,, Office.

I was taught left arm preferred; double check with right arm reading; if taking antihypertensive the standard hold was 100/60 ; 110/60 and the higher reading comparing R to L was the one to go by, for receiving med. Also finding is reportable due to significance of attributable causes from clotting, to arterial disease, injury, etc. keeping in mind that literally dozens of factors influence BP and often vary from check to check for intrinsic and extrinsic reasons.

psu_213, BSN, RN

3,878 Posts

Specializes in Emergency, Telemetry, Transplant.
if taking antihypertensive the standard hold was 100/60

Not trying to criticize, but be careful with saying there is some overarching hold parameters. I have seen a hold parameter for SBP

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