474 The Nursing Assistant Copyright Goodheart-Willcox Co., Inc. Knowing Factors That Affect Blood Pressure Many factors can affect blood pressure. These factors include the following: • Diet: diets high in salt and fat may lead to higher blood pressure. • Weight: being overweight can lead to higher blood pressure. • Exercise: systolic blood pressure may be higher if a resident does not exercise or exercised right before blood pressure was taken. • Race: African-American individuals tend to have a higher occurrence of high blood pressure and at an earlier age compared to Caucasians or people of Hispanic descent. • Time of day: blood pressure may be lower in the morning than later in the day and may be higher after a meal. • Position: blood pressure may be higher if a resident is lying down and lower if a resident is standing up. • Cigarettes and alcohol: using cigarettes and alcohol can increase blood pressure. • Drugs or medications: some medications and drugs can make blood pressure higher or lower. • Stress, fear, or pain: blood pressure may be higher if a resident is experiencing stress, fear, or pain. Remember Ability is what you’re capable of doing. Motivation determines what you do. Attitude determines how well you do it. Lou Holtz, coach Average Blood Pressure Measurements Age Systolic Pressure Diastolic Pressure Adult 100–130 60–90 Teenager 94–134 64–84 Children 100–120 60–74 Infant 70–90 50–64 Figure 18.25 These ranges represent the average blood pressures for adults, teenagers, children, and infants. Becoming a Holistic Nursing Assistant Taking Vital Signs To provide holistic care when measuring and recording vital signs, you can use the following guidelines: • Be knowledgeable about the function of and the normal ranges for different vital signs. • Demonstrate skill and proficiency. • Ensure accurate measurements. Repeat the measurement if you are unsure of a reading. Explain to the resident that you want to take an accurate reading. • Ask a member of the licensed nursing staff for help if you have trouble measuring a vital sign. Never make up a reading. • Quickly report any abnormal results to the licensed nursing staff. • When appropriate, give residents choices about the procedure. For example, you might let the resident choose the arm used to measure blood pressure or choose whether to sit up or lie down. • Know that vital signs can be variable and are unique to each resident, the resident’s environment, and factors of daily living such as diet and exercise. • Maintain a professional and patient attitude when taking vital signs. Never show frustration or concern if you are having difficulty measuring a vital sign or if a vital sign is not in a normal range. Apply It 1. Would any of these guidelines be challenging for you to follow? Explain your answer. 2. From your personal perspective, which guidelines would require more attention or practice on your part?