Taking BP w/ A-Fib

[Chica17]

OK I feel dumb for asking this question but I just kind of like to know the "why" of things. I'm a nursing student and work as a CNA. I was taking a pt's blood pressure manually & noticed the absence and random heart beats,like I would hear the heart beat..then random silence..then a beat here and there, the needle jumping.. so when I told the nurse she said the pt has A-fib so I was like OK I understand that, he has an irregular heart beat, but I had taken the blood pressure a few times and got pretty different readings each time for the systolic number. I don't know if it is just because it was my first time taking a bp with someone who has a-fib or flutter so I was having a difficult time reading the bp or is patient's with a-fib still suppose to have a steady bp? I guess my question is, how are you suppose to take a good bp reading with someone who has this condition? Are the readings different each time or should the bp genereally be the same?

:redbeathe:redbeathe:D Thanks!!

[jrsmrs]

I can't vouch for this, and it's only my opinion, but I would take the BP really slowly (ie, let the needle fall slowly) and take the highest of 3 attempts.

My thought process being that if you let the needle fall slowly you'd be most likely to get a beat before the needle dropped very low, ie at a more accurate number. And I'd do it x3 because if it says 140 systolic once and the other numbers are lower, I would assume the lower numbers were due the the irregular beats and the unusually long pauses in HR and the fact that the first beat took so long to happen that the needle was already lower than it should be.

Again, this is just my own 'critical thinking' so I could be totally wrong, lol, so if someone knows the actual right way to do it, please share!

[SolaireSolstice, BSN, RN]

I was taught to take 3 BPs a few minutes apart each and take the average. BP can fluctuate a bit especially with position changes, like maybe around 10mmHg, but shouldn't greatly. Pump the cuff up to where you can't hear the beat anymore, then about 20 mmHg more. Deflate slowly. The first beat you hear when you deflate is the systolic, even if the beat is irregular.